The Impact of a Structured Contraceptive Counseling Program on Reproductive Health Knowledge, Sexual Autonomy, and Mental Well-Being Among Romanian College Women

Background and Objectives: Contraceptive education may influence reproductive health outcomes, foster greater sexual autonomy, and improve mental well-being. The current study investigated the efficacy of a structured contraceptive counseling program on reproductive health knowledge, sexual autonomy, anxiety, and depressive symptoms among Romanian college women. Materials and Methods: A prospective study was conducted during the 2021-2024 academic years, enrolling 240 female students aged 18-26 from the "Victor Babes" University of Medicine and Pharmacy in Timisoara. The participants were divided into two arms: (1) Intervention Group (IG, n = 115), which was provided counseling materials, and (2) Control Group (CG, n = 116), which received no additional counseling. Baseline and post-intervention data were collected using a contraceptive knowledge quiz (CKQ), a sexual autonomy scale (SAS), the WHOQOL-BREF, GAD-7, and PHQ-9. Results: After the 12-week intervention, the IG demonstrated significant improvements in contraceptive knowledge (mean CKQ score: 25.5 +/- 3.1 vs. 20.1 +/- 4.3 in CG, p < 0.001), sexual autonomy (SAS: 82.6 +/- 9.2 vs. 75.7 +/- 10.1, p < 0.001), and psychological well-being indicators: lower anxiety (GAD-7: 3.1 +/- 2.0 vs. 5.2 +/- 2.3, p < 0.001) and depression scores (PHQ-9: 4.8 +/- 2.0 vs. 7.1 +/- 2.2, p < 0.001). Multiple regression analysis showed that membership in the IG was the most significant predictor of improved post-intervention contraceptive knowledge and reduced mental distress, even after adjusting for confounders such as age, socioeconomic status, and relationship status. Conclusions: A structured contraceptive counseling program can significantly enhance reproductive health knowledge, strengthen sexual autonomy, and reduce depressive and anxiety symptoms among Romanian college women. The findings emphasize the importance of developing systematic, multi-faceted interventions for improving students' reproductive well-being and mental health outcomes within university settings.