A few years back, the Department of Health asked the ACT COE to gather young people’s perspectives on family planning services. With the help of CAPP and PREP providers, we were able to speak with 336 youth in 36 focus groups all over New York State. What we found was, for the most part, not surprising: Many had confidentiality concerns centered around the fear that parents would find out or people would know their business. Youth were afraid of being judged by clinicians and other staff; talking about sex and contraception felt awkward; and clinics did not always seem friendly to youth. There were also fears about getting bad news at a clinic visit.
No surprises there. But to me, one finding did stand out: the overwhelming negative beliefs and attitudes that youth expressed about birth control methods.
Participants were asked to name contraceptive methods that they were aware of and briefly discuss each method. Our researchers counted the number of negative vs. positive remarks made about each contraceptive method – and in nearly every case, the negative comments far outweighed the positive comments.
Negative comments most often referred to side effects they had heard about, as well as perceived lack of reliability. Emergency contraception in particular was considered dangerous – and had five times as many negative comments as positive. The only method where the good edged out the bad? Abstinence. Abstinence was not mentioned as frequently as other methods, but youth clearly understood that it is the most effective way to prevent pregnancy. (It was also largely seen as unrealistic.)
This study is several years old. More recently, researchers in South Carolina* conducted a small focus group study with black and Latina/o youth in two counties. They found many of the same themes: young people expressed the need for private, confidential services in an environment that is friendly to teens. And again, negative feelings about birth control surfaced – especially with respect to side effects. As one teen put it when talking of contraception commercials, “I hate it when they say side effects may include dizziness, drowsiness, heart disease…I say no thank you.”
We know we need to work on the perception and reality of confidential services for youth. At the same time, let’s make sure youth are getting positive messages about birth control. The good news is, they’ve received positive messages about abstinence, and these messages appear to be getting through. How can we present other methods in a positive light as well? Teens who are now or will soon be sexually active do need to know the side effects of any method they are considering, but are they also hearing about convenience, effectiveness, ease of use, and accessibility?
What are your thoughts? Do you have strategies to share? Let us know in the comments.
*Galloway, C. T., Duffy, J. L., Dixon, R. P., & Fuller, T. R. (2017). Exploring African-American and Latino Teens’ Perceptions of Contraception and Access to Reproductive Health Care Services. Journal of Adolescent Health, 60(3, Supplement), S57–S62. https://doi.org/10.1016/j.jadohealth.2016.12.006
You can find more on the ACT for Youth study here: Youth and Family Planning: Findings from a Focus Group Study (PDF)