title: Discouraging trends in reproductive health service use among adolescent and young adult women in the USA, 2002-2008.
abstract: BACKGROUND
  To investigate reproductive health service use by young women in the USA between 2002 and 2008.
  
  
  METHODS
  Using data from two waves of The National Survey of Family Growth, we investigated reproductive health service utilization among women aged 15-24 years (2002 n=2157; 2006-2008 n=2264). Descriptive and univariate statistics and multivariate regression models were employed to describe types of reproductive health services used and compare service use across years. Analyses focused on questions regarding specific recent use of reproductive health services (within the previous 12 months).
  
  
  RESULTS
  Over half the pooled sample (n=4421) reported lifetime family planning clinic (58%) and recent reproductive health service (59%) use, including contraceptive (48%), gynecological exam (47%) and counseling (37%) services. Lifetime family planning service use declined by 15% from 2002 to 2008 (P<0.001) and recent reproductive health service use by 8% (P=0.01), including gynecological exam (8%, P= 0.03) and contraceptive (6%, P= 0.02) services. By 2006-2008, women were less likely to use reproductive health and contraceptive services than in 2002 [odds ratio (OR) 0.6, confidence interval (CI) 0.5, 0.8, P< 0.001 and OR 0.7, CI 0.6, 0.9, P= 0.005, respectively]. Trends were similar but smaller in magnitude among the sexually experienced women, with a 5% decline in both reproductive health (OR 0.7, CI 0.6, 1.0, P= 0.02) and contraceptive (OR 0.8, CI 0.6, 1.0, P= 0.03) service use.
  
  
  CONCLUSIONS
  Reproductive health service use among young women in the USA has declined over the past decade. Public health and policy strategies are needed to promote service use, ultimately to improve reproductive health outcomes.
authors.affiliation: Office of Population Research, Center for Health and Wellbeing, Princeton University, Princeton, NJ 08544, USA. kshall@princeton.edu
authors.forename: Kelli
authors.initials: K
authors.lastname: Stidham Hall
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.forename: James
authors.initials: J
authors.lastname: Trussell
mesh_terms: D000293:Adolescent; D000328:Adult; D003268:Contraception Behavior; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006801:Humans; D060728:Reproductive Health; D034121:Reproductive Health Services / Q000706:statistics & numerical data* / Q000639:trends; D012959:Socioeconomic Factors; D014481:United States