Pregnancy test taking is a correlate of unsafe sex, contraceptive nonadherence, pregnancy, and sexually transmitted infections in adolescent and young adult women

Objectives: This study was conducted to examine the hypotheses that adolescent and young adult pregnancy test takers are at increased risk for unsafe sex, oral contraception (OC) nonadherence, and higher pregnancy and sexually transmitted infection (STI) rates. Methods: We conducted secondary analyses using data collected for a study on OC adherence among 1155 women 16-24 years of age. Data collected at baseline and 3, 6, and 12 months were used for the analyses. Results: At baseline, 33% of women reported having undergone ≥1 pregnancy test at home or a clinic during the past 3 months. Pregnancy test takers were more likely to have ≥3 sexual partners (odds ratio [OR] 2.12; 95% confidence interval [CI] 1.49-3.02) in the past year, report unprotected oral (OR 1.48; 95% CI 1.28-1.72) or anal sex (OR 1.78; 95% CI 1.32-2.39), be diagnosed with an STI (OR 1.76; 95% CI 1.23-2.51), become pregnant (hazards ratio 1.52; 95% CI 1.10-2.10), or not use any birth control method (OR 2.11; 95% CI 1.66-2.60). Moreover, they were less likely to continue using OC that was prescribed at baseline (OR 0.38; 95% CI 0.31-0.47) and to report being ambivalent about pregnancy (OR 0.73; 95% CI 0.60-0.90) compared to non-test takers. Conclusions: Pregnancy test taking is an important correlate of high-risk sexual behaviors, OC nonadherence, and risk of subsequent pregnancy and STIs among adolescent and young adult women. Future interventions should target these women to decrease the risk of unintended pregnancies and STIs.