Relationship Between Dating Violence and Contraceptive Use Among Texas Adolescents

Abstract

The recent overturning of Roe v. Wade has the potential to adversely impact reproductive health among adolescents experiencing unplanned pregnancies from dating violence. We examined the associations between contraceptive use and dating violence among Texas high schoolers in the years leading up to this new law. Youth Risk Behavior Surveillance System data from Texas 9th to 12th graders from 2011, 2013, 2017, and 2019 were analyzed. Multinomial logistic regression analyses examined the association between contraceptive use and key descriptive predictors (physical and/or sexual dating violence, survey year, age, sex, and race/ethnic group). Eleven percent of Texas adolescents surveyed reported experiencing either physical or sexual dating violence and 2% reported experiencing both types of violence. Those who experienced any dating violence were significantly more likely to report not using contraception versus those who did not experience violence (12.5% vs. 68.3%, p = 0.01). Adolescents who experienced any type of dating violence were more likely to report using hormonal contraception, condom use, or withdrawal versus those who did not experience dating violence. Hispanic adolescents were 63% more likely than their ethnic group counterparts to use no contraception (odds ratio [OR] 1.63; 95% confidence interval [CI] [1.11–2.40]). A significant proportion of Texas adolescents reported experiencing dating violence, and this group also reported higher noncontraception use versus those not experiencing dating violence. Given new strict Texas antiabortion laws, dating violence prevention and contraceptive use promotion to prevent unwanted reproductive outcomes such as sexually transmitted infections or unplanned pregnancies are imperative in this age group.

Keywords

adolescents contraceptives condoms dating violence hormonal contraceptives sexual health Texas youth violence YRBS

Introduction

Adolescence is an important developmental stage as children transition from childhood to early adulthood. From ages 10–19 years (World Health Organization, 2014), young adults go through physical, social, emotional, intellectual, and cognitive changes, leading to increased growth, maturity, and a higher propensity for risky behavior (Youth.gov, n.d.). During the mid-to-late stages of this developmental stage, it is normal for adolescents to initiate sexual activity with intimate partners which can help promote the adaptation of healthy adult behaviors and relationships (Caouette et al., 2018). However, there is also an increased risk of unintended health outcomes, such as unplanned pregnancies and sexually transmitted infections (STIs) (Szucs et al., 2020). Specifically, according to the 2019 Youth Risk Behavior Survey (YRBS), 38% of adolescents in high school ever had sexual intercourse, 27% were sexually active, with their most recent intercourse occurring at most 3 months before the survey (Centers for Disease Control and Prevention, n.d.; Raidoo & Kaneshiro, 2017). Regarding adolescent pregnancy, the 2019 national birth rate for females aged 15–19 in the United States decreased by 4% from 2018, falling from 17.4 to 16.7 births per 1000 (Martin et al., 2021). The birth rate for females aged 15–19 in Texas was 24.0 births per 1,000 in 2019, a slight decrease from the 2018 rate of 25.3 births per 1,000 (Martin et al., 2021; Martin et al., 2019).

On June 24th, 2022, the Supreme Court case Roe v. Wade was overturned, ending the constitutional right to abortion in the United States (Klibanoff, 2022). Texas had one of the most restrictive abortion laws in the country, known as SB8, and the Supreme Court ruling caused a pre-Roe trigger law to be enacted, instantly banning all abortions in the state (Klibanoff, 2022; Najmabadi, 2021). The Texas abortion ban raises both medical and public health concerns surrounding an immediate lack of abortion access in the state (Klibanoff, 2022). In 2010, the estimated abortion rate among adolescents in the United States was 6.0 per 1,000 which underscores the significance of adolescents utilizing abortions as part of maintaining their reproductive health (Sedgh et al., 2015). This reflects a decline in the abortion rate for adolescent girls ages 15–19 between 2008 and 2014, which can be attributed to the increased popularity of long-acting reversible contraception (LARC), like the intrauterine devices (IUDs) and implants (Jones & Jerman, 2017; Lindberg et al., 2016). After Texas’s House Bill 2 restricting procedural and medication abortion in 2013, a noticeable reduction in abortion rates among Texas women were discovered, with increased travel times to clinics causing a severe hinderance in obtaining an abortion (Baum et al., 2016; Bhardwaj et al., 2020; Goyal et al., 2020a, 2020b; Grossman et al., 2014; Myers et al., 2019). It is imperative to measure the potential effects of these bills on adolescent pregnancy rates though rates have declined over time in this age group. Also of concern are the rates of contraceptive use among adolescents, especially coupled with the prevalence of physical and sexually violent relationships. Between 2006 and 2010, 82% of adolescent girls ages 15–19 at risk of unintended pregnancy used contraception, with the external condom being the most common method used at first sex (Guttmacher Institute, 2021). From 2011 to 2013, the three most used contraception methods included the condom, oral hormonal contraceptive (the pill), and withdrawal (Guttmacher Institute, 2021). Dating violence is prevalent among adolescents, with females reporting violence more than males (Khanhkham et al., 2020; Lachman et al., 2019; Miller et al., 2018). Women experiencing physical or sexual violence are less likely to use contraception, but one study suggests that women experiencing physical violence are more likely to use contraception (Chan & Martin, 2009; Kusunoki et al., 2002). In 2019 YRBS, 8.2% of students surveyed reported both physical dating violence and sexual dating violence (Martin et al., 2021).

The reproductive coercion framework can be applied when examining the relationship between dating violence and contraceptive use. Reproductive coercion is defined as a type of interpersonal violence where one partner controls the other partner’s reproductive outcomes through contraception options and pregnancy (Park et al., 2016). Dating violence has been linked to reproductive coercion among the adolescent population which is known to exacerbate adolescent pregnancy rates (Miller et al., 2007; Miller & McCauley, 2013; Park et al., 2016; Wingood & DiClemente, 1997). In some studies, 12–19% of adolescent girls report situations of reproductive coercion, including partners restricting contraceptive access by dissuading birth control use and denying condom usage during intercourse and forced pregnancy (Decker et al., 2014; DiClemente et al., 2001; Hill et al., 2019; Northridge et al., 2017; Silverman et al., 2011). Women in these situations are unable to negotiate contraceptive use, like condom use during sex, and are at a higher risk of facing unintended health consequences (Teitelman et al., 2011). A previous study investigating reproductive coercion among young adults have discovered that young women had an increased risk of experiencing reproductive coercion compared to young men (Swan et al., 2021). Young men experiencing reproductive coercion experience it through the female partner refusing to use contraception during sexual activity in an effort to get pregnant (Black et al., 2010; Moore et al., 2010; Park et al., 2016;). These results were found to be significant among college-aged adults and high school adolescents (Nemeth et al., 2020). Adolescent girls are the most vulnerable to physical and sexual dating violence, with violence appearing at the younger ages of 13–15 years (Decker et al., 2005; Fernandez-Gonzalez et al., 2020; Mumford et al., 2019; Park et al., 2016; Piolanti & Foran, 2022; Silverman et al., 2001, 2004; Wolfe et al., 2009). Studies have shown that reproductive coercion disproportionately affects young women of color, especially African American/Black, Latinx, and multiracial women (Grace & Anderson, 2018; Grace et al., 2022; Cha et al., 2017; Hill et al., 2019; Kraft et al., 2021; Silverman et al., 2011; Wingood & DiClemente, 1997). Dating violence and reproductive coercion can work together among adolescent girls and decrease the likelihood of them using contraception (Kusunoki & Barber, 2019). Adolescent girls reporting dating violence and reproductive coercion also had higher odds of using hormonal contraceptives as their only contraception (Silverman et al., 2011), which aligns with adolescent male perpetrators of dating violence reporting inconsistent or no condom use in the 3 months before the survey (Raj et al., 2007). This can lead to increased risk of an unplanned pregnancy in young women (Barber et al., 2018). However, it should be stated that when it comes to decisions about terminating an unplanned pregnancy, male partners are less coercive in influencing their female partners in terminating or continuing the pregnancy (Grace & Anderson, 2018).

Based on the possible public health implications of the new Texas abortion law and its relationship with the reproductive coercion framework, we aimed to identify the relationship between contraceptive use and dating violence (sexual, physical, or both) among high school-aged Texas adolescents to inform future actions and decisions regarding adolescent reproductive health in the state. We hypothesized that Texas high school students who reported sexual, physical, or both types of dating violence would also have decreased self-report of condom use and increased rates of hormonal birth control (e.g., birth control pills, IUDs, implants, injections, patches, and vaginal rings; White, 2018) over the past decade.

Methods

We analyzed data from the Youth Risk Behavior Surveillance System (YRBSS) for the Texas population from 2011, 2013, 2017, and 2019. We chose these years to analyze the trends of contraception method popularity in the most recent years before the passage of SB8. The YRBSS consists of school-based surveys that sampled 9th to 12th grade students from across the United States (Centers for Disease Control and Prevention, n.d.). The data set was weighted to be representative of the state population and all tests were conducted with survey estimations to account for the sampling design (Centers for Disease Control and Prevention, n.d.). We acquired Texas data from the Texas Department of State Health Services (Texas Department of State Health Services, 2011, 2013, 2017, 2019). Data from 2011 was analyzed and excluded from the multivariate analysis due to the YRBSS only reporting physical violence and no sexual violence that year. Data was not collected in 2015 for the statewide population, and thus was excluded from the final analytical data set. A total of 11,535 adolescent students were surveyed across the 4 years. The UT Health Committee for the Protection of Human Subjects considers a retrospective analysis of public, anonymized data, such as the YRBSS, exempt from review. All data generated or analyzed during this study are included in this published article.

Main Outcome Variables

Contraceptive use was the dependent variable of interest. Two questions were selected from the YRBSS to represent contraceptive use. One question asked “The last time you had sexual intercourse, did you or your partner use a condom?,” with participants responding yes, no, or I have never had sexual intercourse. The second question asked “The last time you had sexual intercourse, what one method did you or your partner use to prevent pregnancy?,” with responses including (i) I never had sexual intercourse; (ii) no method was used to prevent pregnancy; (iii) birth control pills; (iv) condoms; (v) an IUD (such as Mirena or ParaGard) or implant (such as Implanon or Nexplanon); (vi) a shot (such as Depo-Provera), patch (such as Ortho Evra), or birth control ring (such as NuvaRing); (vii) withdrawal or some other method; and (viii) not sure.

The responses from the two questions were merged into one variable representing “contraceptives.” Adolescents responding “yes” to whether they had used a condom at last sexual intercourse were added to those adolescents responding that they had used a condom at last sexual intercourse to prevent pregnancy. Adolescents not sure of the method used to prevent pregnancy were excluded from the analysis (n = 140). The adolescents that responded using birth control pills, an IUD or implant, or a shot, patch, or birth control ring were collapsed to form the “hormonal contraceptives” category. The final categories in this variable were [0]: no contraception; [1]: hormonal; [2]: condoms; and [3] withdrawal or other.

Main Exposure Variables

The primary independent variable was the occurrence of sexual and physical dating violence. Teen Dating Violence was measured based on the YRBSS measurement tool, which includes a biannual self-administered questionnaire distributed to school districts (Centers for Disease Control and Prevention, 2013). YRBSS asked if “During the past 12 months, how many times did someone you were dating or going out with force you to do sexual things that you did not want to do?” and “During the past 12 months, how many times did someone you were dating or going out with physically hurt you on purpose?” Participants reported the number of times they experienced violence on a continuous scale, ranging from zero times to six or more times. There were two primary exposure variables of interest: “physical and sexual dating violence” (abbreviated to “PASDV”) and “physical or sexual dating violence only” (abbreviated to “POSDV”) to assess the occurrence of each type independently and combined. In the POSDV variable, the physical dating violence (PDV) and sexual dating violence (SDV) were assessed independently to show the effects of each type of dating violence on contraception use. In other words, the variable was coded [0]: did not date; [1]: experienced no types of dating violence; [2]: at least one incident of physical dating violence only; and [3]: at least one incident of sexual dating violence only. The PASDV responses were also collapsed into three labels defined as “not dating,” “no violence,” and “at least one incident of physical and sexual dating violence.”

Demographics

Key demographic variables in the analysis included age, sex, and race. Age was reported on a continuous scale, ranging from 12 to 18 years. Sex was measured as male or female. The races captured by YRBSS included American Indian/Alaskan Native, Asian, non-Hispanic Black or African American, Native Hawaiian/Pacific Islander, non-Hispanic White, Hispanic/Latino, Multiple-Hispanic, and Multiple non-Hispanic. American Indian/Alaskan Native, Asian, and Native Hawaiian/Pacific Islander (AI/AN/AS/NHPI) were collapsed into one variable due to less than 10% weighted percentages in the individual categories. Multiple-race Hispanic and multiple-race non-Hispanic were collapsed to represent multiple-race adolescents.

Statistical analysis

Simple descriptive analyses on key demographic (age, sex, race) variables of interest were computed to establish frequency and dispersion. χ² Tests determined the associations between types of contraceptive use and the primary exposure variables. Multinomial logistic regression analyses explored the association between contraceptive use and key descriptive characteristics of the sample, including experiencing physical and/or sexual dating violence, survey year, age, sex, and racial and ethnic group. Crude models were first run for the exposure and outcome variables, and then adjusted for age, sex, and race. The model met assumptions of independence. We conducted a multicollinearity test and discovered a low Variance Inflation Factor (VIF) value of 1.01, therefore confirming multicollinearity to not be an issue. Birth control, IUD/implant, and shot/patch/ring were collapsed into one variable (hormonal contraceptives) in all analyses to increase power. Stata 15.1 statistical software (College Station, TX, USA) was used to perform all analyses (α = .05).

Results

Table 1 displays the demographic characteristics and bivariate associations between key demographic characteristics, exposure, and outcome of the Texas adolescents surveyed across the 4 years. The mean age was 16.06 years (standard deviation [SD] = 1.22) and 51% were male. The three largest race and ethnicity categories were multiple-race (39%), non-Hispanic White (32%), and Hispanic/Latino (13%). Of adolescents surveyed, 11% of adolescents reported experiencing POSDV at least once, 5% of adolescents reported experiencing either PDV or SDV only, and 2% of adolescents reported experiencing PASDV at least once. Race/ethnicity, sex, and dating violence prevalence were significant against none and using any contraceptive. Important results included a greater frequency of adolescents experiencing violence using no forms of contraceptive more than adolescents not experiencing violence.

Table 1.

Demographic Characteristics of Texas Adolescents, 2011–2019 Youth Risk Behavior Surveillance System (N = 11,535).

	Weighted n (Weighted %)
Demographics	No Contraception (n = 849)	Any Contraception^a (n = 3,477)	p
Age (mean, SD) (16.06, 1.22)	16.44 (1.20)	16.47 (1.14)	.72
Race/ethnicity			<.001
American Indian/Alaskan Native, Asian, Native Hawaiian/Pacific Islander (n = 451)	25 (2.75)	84 (2.31)
African American/Black (n = 1116)	79 (11.78)	362 (13.56)
White (n = 3216)	161 (25.12)	1,092 (35.11)
Hispanic/Latino (n = 1736)	157 (15.60)	492 (12.31)
Multiple (Hispanic and non-Hispanic) (n = 4703)	404 (44.75)	1371 (36.71)
Sex			<.001
Female (n = 5,864)	504 (56.90)	1,657 (47.21)
Male (n = 5,634)	343 (43.10)	1,815 (52.79)
Years
2011	337 (39.69)	1,410 (40.55)	.16
2013	224 (26.38)	1,017 (29.25)
2017	139 (16.37)	515 (14.81)
2019	149 (17.55)	535 (15.39)
Dating violence prevalence groups			.03
Did not date (n = 6734)	426 (50.18)	1,742 (50.10)
None (n = 4,168)	329 (38.75)	1,457 (41.90)
Physical dating violence only (n = 235)	41 (4.83)	111 (3.19)	–
Sexual dating violence only (n = 236)	28 (3.30)	94 (2.70)	–
Physical and sexual dating violence (n = 162)	25 (2.94)	73 (2.10)
Dating violence prevalence (combined groups)			.01
None	593 (15.25)	2,648 (68.27)
Physical or/and sexual dating violence	166 (3.97)	510 (12.51)

Note. IUD = intrauterine device.

Birth control, IUD/implant, shot/patch/ring, condoms, and withdrawal.

Contraception Use Among Those Who Reported Physical or Sexual Dating Violence

Among adolescents who reported PDV at least once, 35% reported using a condom at last sexual intercourse, which ranked first in the contraceptive methods used. Almost one-quarter (23%) of adolescents reported never having sex, ranking second among contraceptive methods surveyed. Ranked third and fourth were no contraceptive use (20%) and withdrawal (9%). Birth control, shot/patch/ring, and IUD/implant were ranked fifth, seventh, and eighth, respectively, with 7%, 1%, and 1% of adolescents reporting use (Table 2).

Table 2.

Contraceptive Use Among Adolescents Reporting Physical and/or Sexual Dating Violence, Total and by Year (Frequency, Weighted %).

	Physical OR Sexual Dating Violence					Physical AND Sexual Dating Violence
Contraceptive	No date (n = 1,833)	0 Times (n = 3,675)	Physical only (n = 205)	Sexual only (n = 210)	Total (n = 5,923)	No date (n = 1833)	0 Times (n = 3675)	At least once (n = 129)	Total (n = 5,637)
All years
Never had sex	1,563 (85.27)	1,836 (49.96)	48 (23.41)	81 (38.57)	3,528 (59.56)	1,563 (84.53)	1,836 (49.76)	25 (19.62)	3,424 (60.33)
None	57 (3.11)	329 (8.95)	41 (20.00)	28 (13.33)	455 (7.68)	57 (3.08)	329 (8.68)	25 (17.19)	411 (7.05)
Birth control	11 (0.60)	151 (4.11)	14 (6.83)	10 (4.76)	186 (3.14)	11 (0.99)	151 (4.20)	11 (8.43)	173 (3.25)
Condoms	154 (8.40)	1,038 (28.24)	72 (35.12)	60 (28.57)	1,324 (22.35)	154 (8.87)	1,038 (28.29)	38 (33.08)	1,230 (22.13)
IUD/implant	3 (0.16)	33 (0.90)	3 (1.46)	2 (0.95)	41 (0.69)	3 (0.27)	33 (0.80)	4 (2.19)	40 (0.66)
Shot/patch/ring	4 (0.22)	38 (1.03)	3 (1.46)	7 (3.33)	52 (0.88)	4 (0.50)	38 (1.11)	2 (1.10)	44 (0.86)
Withdrawal	26 (1.42)	197 (5.36)	19 (9.27)	15 (7.14)	257 (4.34)	26 (1.46)	197 (5.58)	18 (13.06)	241 (4.41)
Not sure	15 (0.82)	53 (1.44)	5 (2.44)	7 (3.33)	80 (1.35)	26 (0.50)	197 (1.57)	6 (5.32)	74 (1.31)
Total	1,833 (100)	3,675 (100)	205 (100)	210 (100)	5,923 (100)	1,833 (100)	3,675 (100)	129 (100)	5,637 (100)
2011
Never had sex	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
None	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Birth control	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Condoms	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
IUD/implant	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Shot/patch/ring	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Withdrawal	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Not sure	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
Total	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A
2013
Never had sex	582 (84.96)	829 (48.59)	29 (23.93)	50 (36.76)	1,489 (56.32)	582 (84.30)	829 (48.17)	15 (18.78)	1,426 (57.33)
None	17 (2.48)	138 (8.09)	23 (19.66)	18 (13.24)	196 (7.41)	17 (2.59)	138 (8.08)	17 (21.03)	172 (6.96)
Birth control	4 (0.58)	64 (3.75)	9 (7.69)	6 (4.410	83 (3.14)	4 (0.60)	64 (3.63)	7 (9.86)	75 (2.99)
Condoms	67 (9.78)	520 (30.48)	44 (37.61)	44 (32.25)	675 (25.53)	67 (10.43)	520 (30.18)	25 (29.79)	612 (25.08)
IUD/implant	0 (0.00)	13 (0.76)	1 (0.85)	1 (0.74)	15 (0.57)	0 (0.00)	13 (0.69)	2 (2.95)	15 (0.57)
Shot/patch/ring	1 (0.15)	20 (1.17)	1 (0.85)	3 (2.21)	25 (0.95)	1 (0.11)	20 (1.27)	1 (1.48)	22 (0.95)
Withdrawal	8 (1.17)	97 (5.69)	10 (8.55)	9 (6.62)	124 (4.69)	8 (1.02)	97 (5.99)	10 (10.60)	115 (4.75)
Not sure	6 (0.88)	25 (1.47)	1 (0.85)	5 (3.68)	37 (1.40)	6 (0.95)	25 (1.35)	5 (5.50)	36 (1.37)
Total	685 (100)	1,706 (100)	117 (100)	136 (100)	2,644 (100)	685 (100)	1,706 (100)	82 (100)	2,473 (100)
2017
Never had sex	517 (85.45)	538 (53.53)	10 (24.39)	21 (48.84)	1,086 (64.11)	517 (84.71)	538 (51.45)	4 (22.04)	1,059 (63.22)
None	18 (2.98)	94 (9.35)	11 (26.83)	5 (11.63)	128 (7.56)	18 (3.44)	94 (9.31)	1 (6.10)	113 (7.14)
Birth control	5 (0.83)	39 (3.88)	2 (4.88)	2 (4.65)	48 (2.83)	5 (1.27)	39 (4.80)	1 (4.29)	45 (3.51)
Condoms	50 (8.26)	247 (24.58)	12 (29.27)	8 (18.60)	317 (18.71)	50 (7.70)	247 (25.61)	8 (42.58)	305 (19.29)
IUD/implant	2 (0.33)	9 (0.90)	2 (4.88)	0 (0.00)	13 (0.77)	2 (0.47)	9 (0.92)	0 (0.00)	11 (0.74)
Shot/patch/ring	2 (0.33)	9 (0.90)	1 (2.44)	3 (6.98)	15 (0.89)	2 (0.47)	9 (0.95)	0 (0.00)	11 (0.77)
Withdrawal	10 (1.65)	53 (5.27)	2 (4.88)	4 (9.30)	69 (4.07)	10 (1.79)	53 (5.15)	4 (20.21)	67 (4.09)
Not sure	1 (0.17)	16 (1.59)	1 (2.44)	0 (0.00)	18 (1.06)	1 (0.16)	16 (1.81)	1 (4.79)	18 (1.24)
Total	605 (100)	1,0005 (100)	41 (100)	43 (100)	1,694 (100)	605 (100)	1,0005 (100)	19 (100)	1,629 (100)
2019
Never had sex	464 (85.45)	469 (48.65)	10 (21.28)	10 (32.26)	953 (60.13)	464 (85.39)	469 (48.24)	6 (19.01)	939 (60.62)
None	22 (4.05)	97 (10.06)	7 (14.89)	5 (16.13)	131 (8.26)	22 (3.79)	97 (10.16)	7 (26.74)	126 (8.26)
Birth control	2 (0.37)	48 (4.98)	3 (6.38)	2 (6.45)	55 (3.47)	2 (0.32)	48 (5.08)	3 (11.45)	55 (3.54)
Condoms	37 (6.81)	271 (28.11)	16 (34.04)	8 (25.81)	332 (20.95)	37 (7.25)	271 (28.21)	5 (16.45)	313 (20.70)
IUD/implant	1 (0.18)	11 (1.14)	0 (0.00)	1 (3.23)	13 (0.82)	1 (0.22)	11 (1.24)	2 (6.61)	14 (0.99)
Shot/patch/ring	1 (0.18)	9 (0.93)	1 (2.13)	1 (3.23)	12 (0.76)	1 (0.21)	9 (0.95)	1 (3.86)	11 (0.75)
Withdrawal	8 (1.47)	47 (4.88)	7 (14.89)	2 (6.45)	64 (4.04)	8 (1.54)	47 (5.04)	4 (15.87)	59 (4.02)
Not sure	8 (1.47)	12 (1.24)	3 (6.38)	2 (6.45)	25 (1.58)	8 (1.28)	12 (1.08)	0 (0.00)	20 (1.13)
Total	543 (100)	964 (100)	47 (100)	31 (100)	1,585 (100)	543 (100)	964 (100)	28 (100)	1,535 (100)

Note. IUD = intrauterine device.

Condom use was the most prevalent contraceptive method reported from 2013 to 2019, with frequencies between 19 and 38% (Figure 1, Panels A and B). Hormonal contraceptives were the third most popular method among adolescents experiencing PDV or SDV with 9% of respondents reporting use in 2013, but dropped to the fourth most popular in the 2019 PDV sample. Adolescents using no contraceptives fluctuated among the PDV sample, from 20% to 28% to 16% in 2013, 2017, and 2019, respectively. Adolescents using no contraceptives stayed more constant among the SDV sample, from 14% to 12% to 17% across the 3 years. Withdrawal or other method increased from 9% to 16% of adolescents experiencing PDV using this method and stayed constant around 7% among adolescents experiencing SDV between 2013 and 2019 (Figure 1, Panels A and B).

Figure 1.

Contraceptive use among adolescents experiencing physical and/or sexual dating violence from 2011 to 2019: Panels A, B, and C.

Contraception Use Among Those Who Reported Physical and Sexual Dating Violence

Condom use was the most prevalent contraceptive method reported (33%) among adolescents who reported PASDV at least once. Never having sex was the second most prevalent with 20% of adolescents reporting, no contraceptive use was third with 17% of adolescents reporting, and withdrawal ranked fourth with 13% of adolescents reporting this method. Birth control, IUD/implant, and the shot/patch/ring were ranked fifth, seventh, and eighth, respectively, with 8%, 2%, and 1% of adolescents reporting use (Table 2).

Figure 1, Panel C, shows an increase followed by sudden decrease in condom use, from 32% in 2013 to 44% in 2017 to 18% in 2019. Hormonal contraceptives showed the opposite pattern, from 13% in 2013 to 6% in 2017 to 21% in 2019. Adolescents not using any contraceptive fluctuated from 22% in 2013 to 6% in 2017 to 25% in 2019. Adolescents withdrawing also fluctuated from 12% in 2013 to 22% in 2017 to 14% in 2019.

Multivariable Results of Contraception Type by Dating Violence

Condoms

Logistic regression models showed the odds of condom use were 2.50 (95% CI [1.46–4.28]) times greater among those who reported PDV and 2.48 (95% CI [1.18–5.20]) times greater among those who reported PASDV versus those who reported no violence (Table 3). The odds of male adolescents using condoms was 1.58 times greater than female adolescents (95% CI [1.34–1.85]). Additionally, as adolescents increase age by 1 year, the odds of using condoms at last sexual intercourse was 1.63 times greater than the previous year (95% CI [1.50–1.77]) (Table 3). Race/ethnicity and year were not significant (p > .05) in the sample.

Table 3.

Multinomial Logistic Regression of Contraceptives and Physical and/or Sexual Dating Violence by Texas Sample Characteristics.

	Never Had Sex (n = 3,696)OR (95% CI)	No Contraception (n = 512)OR (95% CI)	Hormonal¹ (n = 317)OR (95% CI)	Condoms (n = 1,454)OR (95% CI)	Withdrawal (n = 296)OR (95% CI)
Dating violence prevalence ²
0 Times	Ref.	Ref.	Ref.	Ref.	Ref.
Physical dating violence only	Ref.	4.10 [2.56–6.58]	2.94 [1.22–7.06]	2.50 [1.46–4.28]	3.69 [2.05–6.64]
Sexual dating violence only	Ref.	2.43 [1.44–4.08]	2.17 [0.92–5.14]	1.65 [0.93–2.91]	2.38 [1.27–4.47]
Physical and sexual dating violence	Ref.	5.37 [2.31–12.48]	6.34 [2.91–13.82]	2.48 [1.18–5.20]	6.88 [4.02–11.79]
YRBS year
2013	Ref.	Ref.	Ref.	Ref.	Ref.
2017	Ref.	1.04 [0.80–1.37]	1.13 [0.76–1.68]	0.76 [0.57–1.00]	0.92 [0.55–1.56]
2019	Ref.	1.18 [0.84–1.66]	1.35 [0.92–1.98]	0.94 [0.77–1.16]	1.02 [0.62–1.68]
Age	Ref.	1.83 [1.62–2.08]	2.22 [1.91–2.59]	1.63 [1.50–1.77]	1.84 [1.52–2.23]
Sex
Female	Ref.	Ref.	Ref.	Ref.	Ref.
Male	Ref.	1.06 [0.84–1.34]	0.62 [0.46–0.83]	1.58 [1.34–1.85]	0.95 [0.67–1.35]
Race/ethnicity
Non-Hispanic White	Ref.	Ref.	Ref.	Ref.	Ref.
American Indian/Alaskan Native, Asian, Native Hawaiian/Pacific Islander	Ref.	0.74 [0.35–1.55]	0.16 [0.03–0.70]	0.56 [0.27–1.15]	0.60 0.26–1.40]
African American/non-Hispanic Black	Ref.	1.17 [0.63–2.17]	0.84 [0.37–1.90]	1.14 [0.77–1.69]	1.08 [0.65–1.82]
Hispanic/Latino	Ref.	1.63 [1.11–2.40]	0.53 [0.31–0.90]	0.97 [0.78–1.20]	1.11 [0.74–1.66]
Multiple (Hispanic and non-Hispanic)	Ref.	1.44 [0.98–2.11]	0.68 [0.42–1.10]	0.97 [0.75–1.24]	1.09 [0.75–1.57]

Note. Bolded text indicates statistically significant estimates. IUD = intrauterine device; YRBS = Youth Risk Behavior Survey.

¹Birth control, IUD/implant, and shot/patch/ring.

²Adjusted for age, sex, and race.

Hormonal Contraceptives

The odds of adolescents who experienced PDV using hormonal contraceptives at last sexual intercourse was 2.94 times greater compared to adolescents that did not experience violence (95% CI [1.22–7.06]) and the odds of adolescents who experienced PASDV using hormonal contraceptives was 6.34 times greater than those adolescents that did not experience violence (95% CI [2.91–13.82]) (Table 3). As adolescents age by 1 year, the odds of using hormonal contraceptives are 2.22 times greater than the previous year (95% CI [1.91–2.59]) (Table 3). The odds of male adolescents using condoms was 0.62 times less than female adolescents (95% CI [0.46–0.83]) (Table 3).

The odds of using hormonal contraceptives among AI/AN/AS/NHPI adolescents experiencing violence was 0.16 times lower compared to non-Hispanic White adolescents (95% CI [0.03–0.70]). The odds of condom use among Hispanic/Latino adolescents experiencing POSDV was 0.53 times lower compared to non-Hispanic White adolescents (95% CI [0.31–0.90]) (Table 3). Year was not significant (p > .05) in the sample.

No contraceptives

For adolescents who reported PDV at least once, the odds of not using contraceptives were 4.10 times greater (95% CI [2.56–6.58]) compared to those that did not experience violence and similarly adolescents reporting SDV at least once were 2.43 times more likely to not use contraception (95% CI [1.44–4.08]). Adolescents reporting PASDV at least once were more than 5 times more likely to not use contraception (OR: 5.37; 95% CI [2.31–12.48]) compared to those that did not experience violence (Table 3).

Among adolescents who experience violence, the odds of not using any form of contraception increased by 83% as their age increased by 1-year increments (OR: 1.83; 95% CI [1.62–2.08]) (Table 3). Among adolescents experiencing violence at least once, the odds of not using contraceptives among Hispanic/Latino adolescents were 1.63 times (95% CI [1.11–2.40]) greater compared to non-Hispanic White adolescents. Year was not significant (p > .05) in the sample.

Withdrawal

The odds of using the withdrawal methods among adolescents experiencing PDV, SDV, and PASDV were 3.69, 2.38, and 6.88 times greater compared to adolescents that never experienced violence, respectively (95% CI [2.05–6.64], [1.27–4.47], [4.02–11.79]) (Table 3). For every year, an adolescent increased in age, and the odds of withdrawal increased by 1.84 (95% CI [1.52–2.23]) (Table 3). Race/ethnicity and year were not significant (p > .05) in the sample.

Discussion

Results here among a repeated cross-sectional sample of Texas youth show significant increase in contraceptive and noncontraceptive use over the past decade (2011–2019). Eleven percent of Texas adolescents surveyed over the past decade reported experiencing either physical or sexual dating violence and 2% reported experiencing both types of violence. Those who experienced any dating violence were significantly more likely to report not using contraception versus those who did not experience violence. Key findings in the analysis in terms of specific types of contraception use include higher rates of hormonal contraceptive and noncontraceptive use among violence victims, increasing contraceptive use with increasing age, and different preference for contraceptive type by race and ethnicity. These findings can inform medical professionals working with adolescent patients and school officials who are tasked with discussing dating violence and contraception use among this age group. Specifically, with a large portion of survey respondents reporting experiencing dating violence, it is imperative to analyze contraceptive use among victims to better protect them from unwanted reproductive outcomes in the future, such as STIs or unplanned pregnancies.

The first key finding was the prevalence of various types of contraceptive use among violence victims. Adolescents who reported experiencing both physical and sexual violence reported using withdrawal over other methods. This is of concern because while withdrawal is a valid contraceptive method when done correctly, it still carries great risk for an unplanned pregnancy to result due to lack of experience (Dude et al., 2013). Condom usage had the smallest odds among adolescents experiencing violence out of the four contraception categories but were slightly more likely to be used by adolescents experiencing physical violence than adolescents not experiencing violence. This contradicts a previous study by Manlove et al. which reported that relationships with higher levels of physical violence also had lower rates of condom use compared to relationships with lower to no levels of physical violence (Manlove et al., 2019). The low rates of contraceptive use among violence victims seems to align with previous studies discussing the difficulties of negotiating contraceptive use in abusive relationships (Teitelman et al., 2011). Victims seem to more likely to use withdrawal as the abusive partner has control over the reproductive outcomes and no contraception method allows the partner to exert power over their victim (Kusonoski et al., 2018). This is prevalent among female victims of violence, with more research needed among male victims of reproductive coercion to understand how forced pregnancy might be involved in their relationships with contraception use.

A second key finding was the significant increase in the use of all four major contraceptive types with every 1-year increase in adolescent age. Hormonal contraceptives had the greatest increase as adolescents aged 1 year, which aligns with other reports (Apter, 2018). Hormonal contraceptives, such as LARCs, have seen a significant increase in the past decade and could be seen in more violent relationships as they are easier to hide from abusive partners, which corresponds with the findings in this study (Lindberg et al., 2016). This should be taken into consideration by medical providers when dealing with adolescents in potentially violent relationships and counselling on the best contraception method to protect themselves. Interestingly, using withdrawal had increased odds for those experiencing violence. This is concerning considering these methods leave both sexes at higher risk of contracting STIs from different partners and increases the risk of unplanned pregnancies (Birgisson et al., 2015). Further research could explore why these populations are neglecting contraception and develop strategies to improve contraceptive use.

The final key finding was the variation in preferred contraceptive method by racial and ethnic groups. Hispanic/Latino youth experiencing physical or sexual violence had lower odds of using hormonal contraceptives but greater odds of using no contraceptives than non-Hispanic White adolescents. Hispanic/Latino adolescents in both POSDV and PASDV analyses along with multiple-race adolescents in the POSDV group both had greater odds of using no contraceptives compared to non-Hispanic White adolescents. A study by Dehlendorf et al. reports Hispanic women have greater disparities in using contraceptives due to lack of knowledge, barriers to access, and distrust in the medical system (Dehlendorf et al., 2014). Further research in this area focusing on what knowledge and attitudes adolescents in different racial and ethnic groups, specifically among multiracial groups, hold toward various contraceptive methods is needed to develop better sexual health education programs regarding contraceptives.

A point of interest in this analysis was almost 40% of adolescents identifying as multiple-race individuals (includes both multiple-race Hispanic and multiple-race non-Hispanic). One reason for the high response level in this category may be due to Hispanic people in Texas identifying not as solely Hispanic but as multiple-race Hispanic (Parker et al., 2015). Only around 13% of adolescents in the present sample identified as Hispanic/Latino which is further evidence that this is occurring. There is a large Hispanic population in Texas and if a significant proportion identify as multiple-race, this may be expanding the multiple-race category and reducing the Hispanic/Latino category. Although this sample uses data from 2011 to 2019, this finding is supported by newly released Census 2020 data which reported a large growth of multiracial people in the United States (Quarshie & Slack, 2021). According to the Census, 33.8 million people report identifying as more than one race after using two questions to determine race and ethnicity, similar to the YRBS methods (Quarshie & Slack, 2021; Centers for Disease Control and Prevention, 2013). Our findings correspond with the new Census data, as there is growth in the population size and diversity within Texas. With more people identifying as multiracial and changes in reporting Hispanic/Latino origin along with ethnicity, it is crucial to investigate the changing diversity within states and how this population manages their reproductive health through educational programs and cultural beliefs, as there is a current lack of research among this population.

Limitations

Some study limitations should be considered. First, the YRBS is self-reported data. Bias can factor by over- or underreporting contraceptive or dating violence instances due to social-desirability or recall bias (Weerakoon et al., 2022). Another limitation includes the dating violence question changing between 2011 and 2013. In 2011, the YRBS excluded sexual dating violence and only focused on physical dating violence which limited our ability to analyze physical and sexual dating violence trends from 2011 to 2019. We chose the data from 2011 to 2019 to analyze the trends of contraception method popularity in the most recent years before the passage of SB8. The results may be biased due to the lack of information about sexual dating violence in 2011. Additionally, since YRBS employs a cross-sectional study design, it is difficult to know whether students had been continuing using contraceptive methods before and after last sex. Further, because the survey question asked students to report only one method of contraception, it is impossible to determine whether students were using more than one type.

A major strength of this study is that this data provides a baseline for identifying the relationships between dating violence victims and contraceptive methods through survey responses. This study calls for more studies to investigate real-life data between contraceptives and dating violence.

Conclusion

Texas high schoolers who experienced any dating violence were significantly more likely to report not using contraception versus those who did not experience violence. Over the past decade, increased contraceptive methods and no contraception both significantly increased among the adolescent population experiencing dating violence, with hormonal contraceptives increasing in popularity over time. Age and race/ethnicity are associated with this relationship, suggesting cultural values and parental teachings may influence if an adolescent engages in contraception use, and if so, what type. A third of the population identifying as multiple-race, demonstrating the growing diversity within the Texas adolescent population.

In light of the Texas abortion law, there is an immediate need for adolescents to become better educated in contraception use and alternatives to maintain positive sexual health. Possible solutions include more inclusive sex education, easier access to contraception, and sexual health support and counseling for adolescents. Medical professionals and school officials can also aid adolescents to better control their reproductive autonomy by providing clear and culturally competent contraception education information. In areas where this might be more difficult, creative solutions and programs must be developed to enable adolescents to access information within the sexual health field that can be extrapolated into sexual health topics, such as teaching skills on healthy relationships and using communication and consent information before sexual intercourse. More youth-based programs will empower future generations to take hold of their health and enter the world with a stable background for relationships and their personal lives.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interests with respect to the authorship and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research and/or authorship of this article: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. NS is supported by the Craig and Galen Brown Foundation Scholarship at Texas A&M University for undergraduate studies.

ORCID iD

Nimisha Srikanth

Author Biographies

Nimisha Srikanth is a Bachelor’s of Science in Public Health student at Texas A&M University and intern at the School of Public Health at the University of Texas Health Science Center. Her research focuses on adolescent sexual health and craniofacial measurements of fetuses affected by Fetal Alcohol Syndrome Disorder. She is interested in adolescent sexual health and reproductive justice.

Sitara M. Weerakoon, PhD MPH, is a postdoctoral fellow in the School of Medicine at Yale University. She completed her doctoral degree in the School of Public Health at the University of Texas Health Science Center. Her research focuses on substance use epidemiology with a life course approach. She is interested in substance use in adolescence, adolescent sexual health, and racial and ethnic disparities in adolescent health.

Matthew S. Mathew, MS, is a senior database administrator in the Center for Pediatric Population Health at UTHealth School of Public Health. He is involved in numerous clinical and observational studies in community and health care settings and specializes in data management, analysis, and visualization. His primary research interests are in pediatric health outcomes and childhood obesity and nutrition.

Luyu Xie, PharmD, PhD, is currently a postdoctoral research fellow in the School of Public Health, University of Texas Health Science Center at Houston. Her ongoing research mainly focuses on (1) population-based, pharmacoepidemiological studies in asthma; (2) health outcomes and behaviors of pediatric patients diagnosed with COVID-19; and (3) genetic risk factors detection using Mendelian Randomization.

Sarah E. Messiah, PhD, is the Director of the Center for Pediatric Population Health, a partnership with Children’s Health System of Texas. She researches (1) risk factors for childhood obesity and cardiometabolic disease with emphasis on ethnic group disparities; and (2) dissemination and implementation of evidence-based practices and programs into clinical and community-based settings to prevent childhood-onset obesity and health-related consequences.

References

Apter

(2018). Contraception options: Aspects unique to adolescent and young adult. Best Practice and Research in Clinical Obstetrics and Gynaecology, 48, 115–127. https://doi.org/10.1016/j.bpobgyn.2017.09.010

Barber

J. S.

Kusunoki

Gatny

Budnick

(2018). The dynamics of intimate partner violence and the risk of pregnancy during the transition to adulthood. American Sociological Review, 83(5), 1020–1047. https://doi.org/10.1177/0003122418795856

Baum

S. E.

White

Hopkins

Potter

J. E.

Grossman

(2016). Women’s experience obtaining abortion care in Texas after implementation of restrictive abortion laws: A qualitative study. PLoS One, 11(10), e0165048. https://doi.org/10.1371/journal.pone.0165048

Bhardwaj

N. R.

Murray-Krezan

Carr

Krashin

J. W.

Singh

R. H.

Gonzales

A. L.

Espey

(2020). Traveling for rights: Abortion trends in New Mexico after passage of restrictive Texas legislation. Contraception, 102(2), 115–118. https://doi.org/10.1016/j.contraception.2020.05.003

Birgisson

N. E.

Zhao

Secura

G. M.

Madden

Peipert

J. F.

(2015). Preventing unintended pregnancy: The contraceptive CHOICE project in review. Journal of Women's Health, 24(5), 349–353. https://doi.org/10.1089/jwh.2015.5191

Black

M.C.

Basile

K.C.

Breiding

M.J.

Smith

S.G.

Walters

M.L.

Merrick

M.T.

Chen

Stevens

M.R.

(2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.

Caouette

J. D.

Hudson

K. A.

Bryan

A. D.

Feldstein Ewing

S. W.

(2018). Featured article: Adolescent condom use and connectivity in the social-planful brain. Journal of Pediatric Psychology, 43(8), 821–830. https://doi.org/10.1093/jpepsy/jsy025

Centers for Disease, Prevention

Brener

N. D.

Kann

Shanklin

Kinchen

Eaton

D. K.

Hawkins

Flint

K. H

., Centers for Disease, C., & Prevention. (2013). Methodology of the youth risk behavior surveillance system. Morbidity and Mortality Weekly Report, 62(RR-1), 1–20. https://www.ncbi.nlm.nih.gov/pubmed/23446553

Centers for Disease Control and Prevention. (2019). 2019 Youth Risk Behavior Survey Data. www.cdc.gov/yrbs

10.

Cha

Masho

S. W.

Heh

(2017). Partner violence victimization and unintended pregnancy in Latina and Asian American women: Analysis using structural equation modeling. Women Health, 57(4), 430–445. https://doi.org/10.1080/03630242.2016.1170094

11.

Chan

R. L.

Martin

S. L.

(2009). Physical and sexual violence and subsequent contraception use among reproductive aged women. Contraception, 80(3), 276–281. https://doi.org/10.1016/j.contraception.2009.02.012

12.

Decker

M. R.

Miller

McCauley

H. L.

Tancredi

D. J.

Anderson

Levenson

R. R.

Silverman

J. G.

(2014). Recent partner violence and sexual and drug-related STI/HIV risk among adolescent and young adult women attending family planning clinics. Sexually Transmitted Infections, 90(2), 145–149. https://doi.org/10.1136/sextrans-2013-051288

13.

Decker

M. R.

Silverman

J. G.

Raj

(2005). Dating violence and sexually transmitted disease/HIV testing and diagnosis among adolescent females. Pediatrics, 116(2), e272–e276. https://doi.org/10.1542/peds.2005-0194

14.

Dehlendorf

Park

S. Y.

Emeremni

C. A.

Comer

Vincett

Borrero

(2014). Racial/ethnic disparities in contraceptive use: Variation by age and women’s reproductive experiences. American Journal of Obstetrics and Gynecology, 210(6), 526 e521–e529. https://doi.org/10.1016/j.ajog.2014.01.037

15.

DiClemente

R. J.

Wingood

G. M.

Crosby

R. A.

Sionean

Brown

L. K.

Rothbaum

Zimand

Cobb

B. K.

Harrington

Davies

(2001). A prospective study of psychological distress and sexual risk behavior among black adolescent females. Pediatrics, 108(5), E85. https://doi.org/10.1542/peds.108.5.e85

16.

Dude

Neustadt

Martins

Gilliam

(2013). Use of withdrawal and unintended pregnancy among females 15-24 years of age. Obstetrics & Gynecology, 122(3), 595–600. https://doi.org/10.1097/AOG.0b013e31829d8074

17.

Fernandez-Gonzalez

Calvete

Orue

(2020). Adolescent dating violence stability and mutuality: A 4-year longitudinal study. Journal of Interpersonal Violence, 35(9-10), 2012–2032. https://doi.org/10.1177/0886260517699953

18.

Goyal

Brooks

I. H. M.

Powers

D. A.

(2020). Differences in abortion rates by race-ethnicity after implementation of a restrictive Texas law. Contraception, 102(2), 109–114. https://doi.org/10.1016/j.contraception.2020.04.008

19.

Goyal

Wallace

Dermish

A. I.

Kumar

Schutt-Aine

Beasley

Aiken

A. R. A.

(2020). Factors associated with abortion at 12 or more weeks gestation after implementation of a restrictive Texas law. Contraception, 102(5), 314–317. https://doi.org/10.1016/j.contraception.2020.06.007

20.

Grace

K. T.

Anderson

J. C.

(2018). Reproductive coercion: A systematic review. Trauma Violence Abuse, 19(4), 371–390. https://doi.org/10.1177/1524838016663935

21.

Grace

K. T.

Decker

M. R.

Alexander

K. A.

Campbell

Miller

Perrin

Glass

(2022). Reproductive Coercion, Intimate Partner Violence, and Unintended Pregnancy Among Latina Women. Journal of Interpersonal Violence, 37(3-4), 1604–1636. https://doi.org/10.1177/0886260520922363

22.

Grossman

Baum

Fuentes

White

Hopkins

Stevenson

Potter

J. E.

(2014). Change in abortion services after implementation of a restrictive law in Texas. Contraception, 90(5), 496–501. https://doi.org/10.1016/j.contraception.2014.07.006

23.

Guttmacher Institute. (2021). Contraceptive use among adolescents in the United States. https://www.guttmacher.org/fact-sheet/contraceptive-use-among-adolescents-united-states

24.

Hill

A. L.

Jones

K. A.

McCauley

H. L.

Tancredi

D. J.

Silverman

J. G.

Miller

(2019). Reproductive coercion and relationship abuse among adolescents and young women seeking care at school health centers. Obstetrics & Gynecology, 134(2), 351–359. https://doi.org/10.1097/AOG.0000000000003374

25.

Jones

R. K.

Jerman

(2017). Population group abortion rates and lifetime incidence of abortion: United States, 2008-2014. American Journal of Public Health, 107(12), 1904–1909. https://doi.org/10.2105/AJPH.2017.304042

26.

Khanhkham

Williams

R. D.

Jr. Housman

J. M.

Odum

(2020). Sexual dating violence, school-based violence, and risky behaviors among U.S. High school students. Journal of Community Health, 45(5), 932–942. https://doi.org/10.1007/s10900-020-00811-1

27.

Klibanoff

(2022). With the end of Roe, Texans will have to travel long distances for legal abortions. The Texas Tribune. https://www.texastribune.org/2022/06/23/supreme-court-abortion-roe-dobbs-texas/

28.

Kraft

J. M.

Snead

M. C.

Brown

J. L.

Sales

J. M.

Kottke

M. J.

Hatfield-Timajchy

Goedken

(2021). Reproductive coercion among african american female adolescents: Associations with contraception and sexually transmitted diseases. Journal of Women's Health, 30(3), 429–437. https://doi.org/10.1089/jwh.2019.8236

29.

Kusunoki

Barber

J. S.

(2019). Intimate relationship dynamics and women's expected control over sex and contraception. Contraception, 100(6), 484–491. https://doi.org/10.1016/j.contraception.2019.08.009

30.

Kusunoki

Barber

J. S.

Gatny

H. H.

Melendez

(2018). Physical intimate partner violence and contraceptive behaviors among young women. Journal of Women's Health, 27(8), 1016–1025. https://doi.org/10.1089/jwh.2016.6246

31.

Lachman

Zweig

Dank

Yahner

(2019). Patterns of help-seeking behavior among victims of teen dating violence and abuse: Variations among boys and girls. Journal of School Health, 89(10), 791–799. https://doi.org/10.1111/josh.12816

32.

Lindberg

Santelli

Desai

(2016). Understanding the decline in adolescent fertility in the United States, 2007-2012. Journal of Adolescent Health, 59(5), 577–583. https://doi.org/10.1016/j.jadohealth.2016.06.024

33.

Manlove

Welti

Karpilow

(2019). Relationship violence typologies and condom use in young adult dating relationships. Perspectives on Sexual and Reproductive Health, 51(2), 109–117. https://doi.org/10.1363/psrh.12104

34.

Martin

J. A.

Hamilton

B. E.

Osterman

M. J. K.

Driscoll

A. K.

(2019). Births: Final data for 2018. National Vital Statistics Reports, 68(13), 1–47. https://www.ncbi.nlm.nih.gov/pubmed/32501202

35.

Martin

J. A.

Hamilton

B. E.

Osterman

M. J. K.

Driscoll

A. K.

(2021). Births: Final data for 2019. National Vital Statistics Reports, 70(2), 1–51. https://www.ncbi.nlm.nih.gov/pubmed/33814033

36.

Miller

Decker

M. R.

Reed

Raj

Hathaway

J. E.

Silverman

J. G.

(2007). Male partner pregnancy-promoting behaviors and adolescent partner violence: Findings from a qualitative study with adolescent females. Ambulatory Pediatrics, 7(5), 360–366. https://doi.org/10.1016/j.ambp.2007.05.007

37.

Miller

Jones

K. A.

McCauley

H. L.

(2018). Updates on adolescent dating and sexual violence prevention and intervention. Current Opinion in Pediatrics, 30(4), 466-471. https://doi.org/10.1097/MOP.0000000000000637

38.

Miller

McCauley

H. L.

(2013). Adolescent relationship abuse and reproductive and sexual coercion among teens. Current Opinion in Obstetrics and Gynecology, 25(5), 364–369. https://doi.org/10.1097/GCO.0b013e328364ecab

39.

Moore

A. M.

Frohwirth

Miller

(2010). Male reproductive control of women who have experienced intimate partner violence in the United States. Social Science & Medicine, 70(11), 1737–1744. https://doi.org/10.1016/j.socscimed.2010.02.009

40.

Mumford

E. A.

Liu

Taylor

B. G.

(2019). Longitudinal trajectories of perpetration of adolescent dating abuse in a national sample. Aggressive Behavior, 45(3), 327–336. https://doi.org/10.1002/ab.21822

41.

Myers

Jones

Upadhyay

(2019). Predicted changes in abortion access and incidence in a post-Roe world. Contraception, 100(5), 367–373. https://doi.org/10.1016/j.contraception.2019.07.139

42.

Najmabadi

(2021). Gov. Greg Abbott signs into law one of nation's strictest abortion measures, banning procedure as early as six weeks into a pregnancy. https://www.texastribune.org/2021/05/18/texas-heartbeat-bill-abortions-law/.

43.

Nemeth

J. M.

Viveiros

Lynch

K. R.

Anderson

T. S.

Fisher

(2020). Adolescent reproductive and sexual coercion: Measurement invariance in a population-based sample of male and female high school students. Journal of Family Violence, 35, 619–632. https://doi.org/10.1007/s10896-019-00092-w

44.

Northridge

J. L.

Silver

E. J.

Talib

H. J.

Coupey

S. M.

(2017). Reproductive coercion in high school-aged girls: Associations with reproductive health risk and intimate partner violence. Journal of Pediatric and Adolescent Gynecology, 30(6), 603–608. https://doi.org/10.1016/j.jpag.2017.06.007

45.

Park

Nordstrom

S. K.

Weber

K. M.

Irwin

(2016). Reproductive coercion: Uncloaking an imbalance of social power. American Journal of Obstetrics and Gynecology, 214(1), 74–78. https://doi.org/10.1016/j.ajog.2015.08.045

46.

Parker

Horowitz

J. M.

Morin

Lopez

M. H.

(2015). Hispanic racial identity: Multidimensional issue for Latinos. https://www.pewresearch.org/social-trends/2015/06/11/chapter-7-the-many-dimensions-of-hispanic-racial-identity/.

47.

Piolanti

Foran

H. M.

(2022). Efficacy of interventions to prevent physical and sexual dating violence among adolescents: A systematic review and meta-analysis. JAMA Pediatrics, 176(2), 142–149. https://doi.org/10.1001/jamapediatrics.2021.4829

48.

Quarshie

Slack

(2021). Census: US sees unprecedented multiracial growth, decline in the white population for first time in history. https://www.usatoday.com/story/news/politics/2021/08/12/how-2020-census-change-how-we-look-america-what-expect/5493043001/.

49.

Raidoo

Kaneshiro

(2017). Contraception counseling for adolescents. Current Opinion in Obstetrics and Gynecology, 29(5), 310–315. https://doi.org/10.1097/GCO.0000000000000390

50.

Raj

Reed

Miller

Decker

M. R.

Rothman

E. F.

Silverman

J. G.

(2007). Contexts of condom use and non-condom use among young adolescent male perpetrators of dating violence. AIDS Care, 19(8), 970–973. https://doi.org/10.1080/09540120701335246

51.

Sedgh

Finer

L. B.

Bankole

Eilers

M. A.

Singh

(2015). Adolescent pregnancy, birth, and abortion rates across countries: levels and recent trends. Journal of Adolescent Health, 56(2), 223–230. https://doi.org/10.1016/j.jadohealth.2014.09.007

52.

Silverman

J. G.

McCauley

H. L.

Decker

M. R.

Miller

Reed

Raj

(2011). Coercive forms of sexual risk and associated violence perpetrated by male partners of female adolescents. Perspectives on Sexual and Reproductive Health, 43(1), 60–65. https://doi.org/10.1363/4306011

53.

Silverman

J. G.

Raj

Clements

(2004). Dating violence and associated sexual risk and pregnancy among adolescent girls in the United States. Pediatrics, 114(2), e220–e225. https://doi.org/10.1542/peds.114.2.e220

54.

Silverman

J. G.

Raj

Mucci

L. A.

Hathaway

J. E.

(2001). Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. JAMA, 286(5), 572–579. https://doi.org/10.1001/jama.286.5.572

55.

Swan

L. E. T.

Mennicke

Kim

(2021). Reproductive coercion and interpersonal violence victimization experiences among college students. Journal of Interpersonal Violence, 36(23-24), 11281–11303. https://doi.org/10.1177/0886260519898424

56.

Szucs

L. E.

Lowry

Fasula

A. M.

Pampati

Copen

C. E.

Hussaini

K. S.

Kachur

R. E.

Koumans

E. H.

Steiner

R. J.

(2020). Condom and contraceptive use among sexually active high school students—Youth risk behavior survey, United States, 2019. MMWR Supplements, 69(1), 11–18. https://doi.org/10.15585/mmwr.su6901a2

57.

Teitelman

A. M.

Tennille

Bohinski

J. M.

Jemmott

L. S.

Jemmott

J. B.

3rd . (2011). Unwanted unprotected sex: Condom coercion by male partners and self-silencing of condom negotiation among adolescent girls. Advances in Nursing Science, 34(3), 243–259. https://doi.org/10.1097/ANS.0b013e31822723a3

58.

Texas Department of State Health Services. (2011). 2011 Texas youth risk behavior survey. [Data set]. www.dshs.texas.gov/chs/yrbs.

59.

Texas Department of State Health Services. (2013). 2013 Texas Youth Risk Behavior Survey. [Data set]. www.dshs.texas.gov/chs/yrbs.

60.

Texas Department of State Health Services. (2017). 2017 Texas Youth Risk Behavior Survey. [Data set]. www.dshs.texas.gov/chs/yrbs.

61.

Texas Department of State Health Services. (2019). 2019 Texas Youth Risk Behavior Survey. [Data set]. www.dshs.texas.gov/chs/yrbs.

62.

Weerakoon

S. M.

Keeton

J. M.

Vidot

D. C.

Arheart

K. L.

Messiah

S. E.

(2022). Relationship between risky behaviors and non-prescription opioid use among Asian American youth. Journal of Ethnicity in Substance Abuse, 21(1), 377–386. 1–10. https://doi.org/10.1080/15332640.2020.1772931

63.

White

N. D.

(2018). Hormonal contraception and breast cancer risk. American Journal of Lifestyle Medicine, 12(3), 224–226. https://doi.org/10.1177/1559827618754833

64.

Wingood

G. M.

DiClemente

R. J.

(1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American Journal of Public Health, 87(6), 1016–1018. https://doi.org/10.2105/ajph.87.6.1016

65.

Wolfe

D. A.

Crooks

Jaffe

Chiodo

Hughes

Ellis

Stitt

Donner

(2009). A school-based program to prevent adolescent dating violence: a cluster randomized trial. Archives of Pediatrics & Adolescent Medicine, 163(8), 692–699. https://doi.org/10.1001/archpediatrics.2009.69

66.

World Health Organization. (2014). Recognizing adolescence. https://apps.who.int/adolescent/second-decade/section2/page1/recognizing-adolescence.html

67.

Youth.gov. (n.d.). Adolescent health. https://youth.gov/youth-topics/adolescent-health#_ftn