Original article
Determinants and Correlates of Preventive Behaviors at First Sex With a First Partner and Second Partner: Analysis of the FECOND Study

https://doi.org/10.1016/j.jadohealth.2016.03.006Get rights and content

Abstract

Purpose

This study explores transitions in contraceptive use in early sexual life in France and has three objectives: describe predictors of contraceptive use at first sex with first and second partners, describe contraceptive trajectories in these partnerships, and test associations between use at first sex and switching in first partnership on use with second partner.

Methods

Our analyses include 1,823 participants, aged 15–29 years, of the 2010 French national sexual health survey who reported at least two lifetime sexual partners and a subset of 1,593 people who report contraceptive use throughout their first partnership. We use logistic regression and generalized estimating equation models to investigate the three objectives.

Results

Our results reveal a decline in contraceptive use between first and second partner, driven primarily by decreases in condom use, from 87.9% to 79.5% between first and second partner. This is partially offset by an increase in use of effective methods (from 7.8% to 38.1%), particularly by women. Any method use and discontinuation with first partner were predictors of patterns with second partner.

Conclusions

Analysis of early transitions in contraceptive use of adolescents in early sexual life reveals shifts from sexually transmitted infection to pregnancy prevention and an increase in unprotected sex.

Section snippets

Methods

The FECOND study, a national probability survey conducted in France in 2010, addresses sexual and reproductive health in the French population. A sample of 8,645 individuals aged 15–49 years was identified using random digit dialing (including landlines and cellphones). One individual per phone number was selected for participation. After orally consenting, participants responded to telephone interviews, which lasted an average of 41 minutes. The FECOND study was approved by the French agency

Description of study sample and contraceptive use

The sociodemographic characteristics of “population 2” (n = 1,823) and the “population switch” (n = 1,593) were similar to the larger population (n = 2,657) (Table 1) (less than 1% of either males or females had missing data for any variable). The mean age of “population 2” was 23.2 years; 31% had not completed high school at the time of the survey, and 29% had some college or graduate education; 47% reported it had been easy to talk with their mother about sexuality, whereas a little over a

Discussion

This study reveals changes in preventive behaviors during the early stages of sexual life. Over time, young people in France move toward use of more effective contraceptive methods but are less likely to use condoms—including at first intercourse with their second partner. This is a positive shift for the purpose of pregnancy prevention but a challenge in terms of STI prevention. The decline in condom use is concerning as the risks of STIs are high in this age group [14], [15] while switching

Funding Sources

H.L. was supported by the National Institute of Allergy and Infectious Disease (T32 AI050056-12). C.M. was supported by the William Robertson endowment funds.

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