BACKGROUND

Sexual debut before age 15 years has been associated with increased sexual risk behaviors among teens, but little is known about its effects beyond adolescence. This study examines the relationship between the age at first intercourse and subsequent contraceptive gaps.

METHODS

We identified 3538 sexually active, fertile women participants from the 2006-2008 National Survey of Family Growth. Women were classified as consistent contraceptive users or inconsistent/nonusers. Age at first intercourse with a man was determined by self-report and categorized as <15, 15-17, and ≥18 years.

RESULTS

Twenty-three percent reported gaps in contraceptive use in the year prior to interview. Compared with women who were 18 or older at first intercourse, women who were <15 years of age at the time of first intercourse were nearly two times as likely to report a gap in contraceptive use (adjusted odds ratio: 1.93; 95% confidence interval: 1.23-3.00).

CONCLUSIONS

Age at first intercourse is associated with inconsistent or nonuse of contraceptives in later life. Primary prevention efforts should be established to empower girls to make informed and autonomous decisions about sexual debut. Personalized contraceptive counseling has been demonstrated as being effective in increasing contraceptive use and compliance and should be offered to all women, with particular focus on women who report an early age at first intercourse or other factors associated with inconsistent contraceptive use.