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Does free contraceptives promote promiscuity?

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A study was conducted to determine whether free contraception was associated with the number of sexual partners and frequency of intercourse over time. Researchers at Washington University in St. Louis School of Medicine (St. Louis, Missouri) published their findings online on March 5 in the journal Obstetrics & Gynecology.

The investigators note that a study reported that providing contraception at no cost and educating women about the most effective contraceptive methods can reduce the rate of unintended pregnancy and abortion. These findings were from the Contraceptive CHOICE Project in St. Louis, Missouri. The medical community acknowledges the benefits of increased access to effective contraception; however, others in our society are less enthusiastic. For example, the Family Research Council has raised concerns that increased access to contraception may actually result in an increase in the number of unintended pregnancies, presumably by increasing sexual activity. Thus, the question of whether increased access to contraception changes sexual behavior in unanticipated ways is of significant importance. The study authors note that “reliance on data rather than intuition is advisable.” Therefore, they conducted a study to estimate whether providing free contraception is associated with a change in the number of sexual partners and frequency of intercourse over time. The research involved participants enrolled in a large study of reversible contraception.

The investigators analyzed data from the Contraceptive CHOICE Project, which was a prospective (forward-looking) study of 9,256 adolescents and women at risk for unintended pregnancy. The women were provided reversible contraception of their choice at no cost and were followed-up with telephone interviews at 6 and 12 months. The researchers assessed the number of male sexual partners and frequency of intercourse reported during the previous 30 days at baseline compared with 6 months and 12 months after the subjects received their free contraception.

Of the total group, 7,751 (84%) of the women and adolescents completed both 6-month and 12-month surveys; thus, they were included in the analysis. The researchers observed a statistically significant decrease in the number of women and adolescents who reported more than one sexual partner during the past 30 days from baseline to 12 months (5.2% to 3.3%). The majority of the women (70-71%) reported no change in their number of sexual partners at 6 and 12 months; however, 13% reported a decrease and 16% reported an increase. More than 80% of participants who reported an increase in the number of partners experienced an increase from zero to one partner. The frequency of intercourse increased during the past 30 days from baseline (average: 4) to 6 and 12 months (average: 6). However, an increased frequency of intercourse did not result in an increased incidence of sexually transmitted diseases (STDs) at 12 months.

The investigators concluded that they found little evidence to support concerns of increased sexual risk-taking behavior subsequent to greater access to no-cost contraception.