Factors Associated with Contraceptive Use in Women Who Have Sex with Women and Men: An Exploratory Analysis

Women who have sex with women and men (WSWM) are less likely to use effective contraception and more likely to experience unintended pregnancies than their exclusively heterosexual peers. The authors examined contraception use among a community sample of 80 WSWM (defined as genital contact with at least one cisgender man and woman during the past 12 months) of reproductive age living in the Midwest. Authors determined if contraceptive use differed by sociodemographic characteristics, or sexuality and relationship characteristics, and used a modified timeline follow-back calendar to explore contraception use during most recent penile-vaginal intercourse (PVI). Overall, use of highly effective contraception was low (38.8%) with combined hormonal contraceptive pills reported most frequently (54.8%). Of participants who engaged in PVI during their most recent sexual event with a male, nearly one half (46.1%) reported using at least one form of contraception. WSWM with a primary sexual attraction to men were more likely to use contraception (p <.01), as were those who recently engaged in PVI (p <.05). Self-identified lesbian participants were less likely than all others to use contraception (p <. 05). WSWM not planning to engage in sex with men may not use contraceptives consistently or at all, suggesting an area where inclusive contraception counseling can improve the reproductive health of women who have sex with women and men.