title: Lower use of sexual and reproductive health services among women with frequent religious participation, regardless of sexual experience.
abstract: OBJECTIVE
  To investigate associations between religious characteristics and sexual and reproductive health (SRH) service use among young women in the United States.
  
  
  METHODS
  We combined two cycles of data from the U.S. population-based reproductive health survey, The National Survey of Family Growth (2002 and 2006-2008). Our analysis was restricted to young women aged 15-24 years (n=4421). We tested relationships between religious characteristics, including religious affiliation, service participation, and importance of religion in daily life, and use of SRH services for contraception, sexually transmitted infection (STI) testing/treatment, and routine gynecologic examination care within the last year.
  
  
  RESULTS
  Nearly all young women identified a current religious affiliation (82%), with 46% identifying Protestant and 28% Catholic. Three quarters (75%) of young women reported current religious service participation, the majority of whom had experienced sexual intercourse (70%); 31% reported weekly religious service participation. Over half (59%) had used SRH services recently. In unadjusted analyses, young women with current religious affiliation who participated in services weekly and deemed religion important had lower proportions of SRH service use than their counterparts (all p<0.001). In multivariate regression models, young women with less-than-weekly religious service participation were 50% more likely to use services than those participating weekly (odds ratio [OR] 1.5, confidence interval [CI] 1.3, 2.1, p<0.001), even among sexually experienced women.
  
  
  CONCLUSIONS
  Increasing frequency of current religious service participation was negatively associated with SRH service use among young women, despite sexual experience. Religiously and sexually active young women in the United States may have an unmet need for SRH care.
authors.affiliation: Office of Population Research, Center for Health and Wellbeing, Princeton University, Princeton, NJ 08544, USA. kshall@princeton.edu
authors.forename: Kelli Stidham
authors.initials: KS
authors.lastname: Hall
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.forename: James
authors.initials: J
authors.lastname: Trussell
mesh_terms: D000293:Adolescent; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D012069:Religion and Psychology; D012071:Religion and Sex; D043762:Reproductive Behavior / Q000523:psychology*; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult