Reasons for Having Unprotected Sex Among Adolescents and Young Adults Accessing Reproductive Health Services

Introduction: Although research suggests that young people are more likely to have unprotected sex than adults, their reasons for doing so are not well-understood. Among a sample of young people accessing no-cost contraceptive services, we explored their reported reasons for having unprotected sex and their willingness to have unprotected sex in the future. Methods: We recruited sexually active assigned female at birth youth at 10 family planning clinics in the San Francisco Bay Area (n = 212). Participants completed a self-administered survey reporting their reasons for having unprotected sex and willingness to do so in the future. We used bivariate analyses to assess associations between reasons for unprotected sex and age group (adolescents ages 14-19 vs. young adults ages 20-25) and willingness to have unprotected sex in the future. Results: Most young people (69%) had recently engaged in unprotected sex and 41% were willing to in the future. The most common reported reasons for having unprotected sex included not planning to have sex, a preference for unprotected sex, and difficulty using contraception. Worrying about contraceptive side effects and a preference for unprotected sex were significantly associated with a willingness to have unprotected sex in the future (p < .01). Age group was not associated with most reasons for having unprotected sex. Conclusions: Person-centered care should give attention to the range of reasons that may influence young people's sexual and contraceptive decision-making. (c) 2022 The Authors. Published by Elsevier Inc. on behalf of Jacobs Institute of Women's Health, George Washington University. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).