CONTRACEPTIVE DISCONTINUATION AMONG WHITE, BLACK, AND HISPANIC ADOLESCENTS

Study Objective: To compare profiles of risk for contraceptive discont inuation among groups of family planning white, black, and Hispanic te enagers. Design: Retrospective chart review comparing groups of patien ts who returned or failed to return for the 3- to 4-month follow-up ap pointment after initiating oral contraceptives. For purposes of analys is, patients were divided into three distinct ethnic groups: white, bl ack and Hispanic. Setting: Family Planning Clinic at the University of Texas Medical Branch, Galveston. Participants: 183 indigent adolescen ts aged less-than-or-equal-to 17 who initiated oral contraceptives bet ween January 1, 1988 and December 31, 1988. Outcome Measure: Contracep tive continuation defined as return to clinic for 3- to 4-month follow -up appointment. Results and Conclusions: Bivariate and multivariate a nalyses conducted to identify risk factors for discontinuation within each ethnic group produced unique profiles of risk. Prior pregnancy an d age <15 were significantly associated with discontinuation among whi tes, with heavy menstrual flow serving as a protective factor. For bla cks, prior abortion and history of vaginitis were significant risk fac tors for discontinuation. Among Hispanics, the risk factors age and pr ior pregnancy and the protective factor previous medical problems were identified. To maximize oral contraceptive compliance, researchers an d clinicians working with multi-ethnic adolescent populations should b e sensitive to cultural differences that may influence treatment compl iance.