Contraceptive discontinuation among white, black, and Hispanic adolescents

Study Objective: To compare profiles of risk for contraceptive discontinuation among groups of family planning white, black, and Hispanic teenagers. Design: Retrospective chart review comparing groups of patients who returned or failed to return for the 3- to 4-month follow-up appointment after initiating oral contraceptives. For purposes of analysis, patients were divided into three distinct ethnic groups: white, black and Hispanic. Setting: Family Planning Clinic at the University of Texas Medical Branch, Galveston. Participants: 183 indigent adolescents aged ≤ 17 who initiated oral contraceptives between January 1, 1988 and December 31, 1988. Outcome Measure: Contraceptive continuation defined as return to clinic for 3- to 4-month follow-up appointment. Results and Conclusions: Bivariate and multivariate analyses conducted to identify risk factors for discontinuation within each ethnic group produced unique profiles of risk. Prior pregnancy and age <15 were significantly associated with discontinuation among whites, with heavy menstrual flow serving as a protective factor. For blacks, prior abortion and history of vaginitis were significant risk factors for discontinuation. Among Hispanics, the risk factors age and prior pregnancy and the protective factor previous medical problems were identified. To maximize oral contraceptive compliance, researchers and clinicians working with multi-ethnic adolescent populations should be sensitive to cultural differences that may influence treatment compliance.