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Black-White Differences in Sex and Contraceptive Use Among Young Women

Demography volume 53, pages 1399–1428 (2016)Cite this article

Abstract

This study examines black-white and other sociodemographic differences in young women’s sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention—long-acting reversible contraception (LARC)—was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds.

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Fig. 1

Notes

  1. More information about the National Center for Health Statistics Healthy People goals can be found online (http://www.cdc.gov/nchs/healthy_people/index.htm).

  2. Throughout this article, the “effectiveness” of contraceptive methods refers specifically to pregnancy prevention. We recognize that condoms are highly effective at sexually transmitted infection (STI) prevention.

  3. RDSL data collection preceded the Affordable Care Act (ACA), which eliminates co-pays for contraception.

  4. Preliminary analyses included separate categories for two-year college, vocational, technical, or other school versus four-year college, but the results did not differ for the two categories. They are combined for parsimony.

  5. Preliminary analyses included separate categories for full-time versus part-time employment, but the results did not differ for the two categories. They are combined for parsimony.

  6. In all analyses of contraceptive use, we eliminate the small number of weeks in which the respondents were pregnant—less than 1 % of the weeks (N = 895 weeks). Fourteen respondents were excluded entirely because they were pregnant during all the weeks they completed interviews during the first 12 months.

  7. Preliminary analyses included separate categories for each method type, but the results did not differ for the methods included in LARC or for those included in Pill; therefore, they were combined for the sake of parsimony. Weeks in which only an “other” method was reported (e.g., spermicide only) or the respondent did not report the specific method used were excluded from this set of analyses because of small sample sizes (less than 1 % of weeks where any contraception was used (n = 46 weeks)).

  8. We also conducted sensitivity analyses for all contraception models (Tables 3, 4, and 5) that excluded weeks in which the respondent had a strong desire to become pregnant (and no desire to avoid pregnancy). The results did not differ from those presented.

  9. Race differences were larger after we controlled for adolescent experiences with sex and pregnancy, indicating that black women experience even less sex and partnerships than we would expect, given their adolescent experiences with sex and pregnancy.

  10. There were no differences in the race coefficient between models that did not include adolescent experiences with sex and pregnancy and models that did.

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Acknowledgments

This research was supported by two research grants from the National Institute of Child Health and Human Development (R01 HD050329, R01 HD050329-S1, PI Barber), a research grant from the National Institute on Drug Abuse (R21 DA024186, PI Axinn), and a population center grant (R24 HD041028) and training grant (T32 HD007339) from the National Institute of Child Health and Human Development to the University of Michigan Population Studies Center. The authors gratefully acknowledge the Survey Research Operations (SRO) unit at the Survey Research Center of the Institute for Social Research for their help with the data collection, particularly Vivienne Outlaw, Sharon Parker, and Meg Stephenson. The authors also gratefully acknowledge the intellectual contributions of the other members of the original RDSL project team (William Axinn, Mick Couper, Steven Heeringa, Heather Gatny), and the National Advisory Committee for the project (Larry Bumpass, Elizabeth Cooksey, Kathie Harris, and Linda Waite).

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Authors and Affiliations

  1. Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, 400 North Ingalls Street, Room 4156, Ann Arbor, MI, 48109, USA

    Yasamin Kusunoki

  2. Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA

    Yasamin Kusunoki, Jennifer S. Barber & Elizabeth J. Ela

  3. Department of Sociology, University of Michigan, 500 S. State Street, Ann Arbor, MI, 48109, USA

    Jennifer S. Barber & Elizabeth J. Ela

  4. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA

    Amelia Bucek

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Kusunoki, Y., Barber, J.S., Ela, E.J. et al. Black-White Differences in Sex and Contraceptive Use Among Young Women. Demography 53, 1399–1428 (2016). https://doi.org/10.1007/s13524-016-0507-5

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