ABSTRACT

This paper explores the use of withdrawal as a harm reduction approach to adolescent pregnancy prevention and its association with condom use. Data come from a baseline survey of a randomised controlled trial to test the effectiveness of FLASH, a sexual health education curriculum. Study participants completed electronic self-report surveys in health classes in their first or second year of high school (age range 14.1–17.9, mean 15.3 years). One-hundred and ninety-one students (12% of full sample) reported engaging in vaginal intercourse in the 3 months prior to the survey; of these, 66.0% reported using withdrawal as a birth control method, without significant differences by race, gender, region or birth control beliefs. Withdrawal was often used in combination with condoms (55.5%), periodic abstinence (40.0%) and birth control pills (13.4%). The effectiveness of withdrawal and its prevalence suggest an opportunity to reflect on how withdrawal is taught – moving from avoiding its use to a harm reduction approach to help sexually active youth avoid risk, reduce risk and reduce potential harm associated with sexual behaviours. Rather than focusing on withdrawal as risky, youth-serving professionals should acknowledge young people’s efforts to prevent pregnancy and recognise the social and relational contexts of contraceptive choices.

抽象的

本文探讨了将戒断作为减少伤害的方法来预防青少年怀孕及其与使用安全套的关系。数据来自对一项随机对照试验的基线调查，以测试性健康教育课程FLASH的有效性。研究参与者在高中的第一年或第二年（年龄范围14.1–17.9，平均15.3岁）在健康课上完成了电子自我报告调查。一百九十一名学生（占全部样本的12％）报告在调查前的三个月内进行了阴道性交；在这些人中，有66.0％的人报告使用戒断作为节育方法，但在种族，性别，地区或节育观念方面没有显着差异。戒断常与避孕套（55.5％），定期戒酒（40.0％）和避孕药（13.4％）结合使用。戒断的有效性及其普遍性表明，有机会思考如何教导戒断–从避免使用戒毒转向减少伤害的方法，以帮助性活跃的年轻人规避风险，减少风险并减少与性行为有关的潜在伤害。为青年服务的专业人员不应将退缩视为风险，而应承认年轻人为预防怀孕所做的努力，并认识到避孕选择的社会和关系背景。