Long-Term Effects of a Community-Based Program on Contraceptive Use Among Sexually Active Unmarried Youth in Shanghai, China

Abstract 

Purpose

To evaluate the long-term (48-month) sustainable effect of a set of community-based interventions to promote contraceptive use among sexually active unmarried youth in suburban Shanghai, China.

Methods

A nonrandomized community trial with one intervention and one control group was conducted in two comparable towns of a suburban area of Shanghai. The intervention program was developed and implemented to increase knowledge and access to sexual and reproductive health services among unmarried youth aged 15–24 years. Baseline surveys were conducted in both sites before implementation of the intervention, and similar surveys were conducted in both sites 20 months after the launch of the intervention and 28 months after the end of the intervention.

Results

Statistically significant differences between the respondents surveyed at baseline in 2000 and at the long-term follow up in 2004 were observed in some age categories and in some educational groups. In the postproject period, there was a major improvement in all indicators in the control group. Among the sub-set of respondents interviewed both in 2000 and 2004 who were exposed to the intervention program, the interventions were associated with a significant increase in the frequency of contraceptive use among participants initiating sexual relations over the period of the intervention (odds ratio [OR] = 6.91), as well as with significant reduction in use ever of the withdrawal method of contraception among all sexually active respondents (OR = .37) compared with the control group during long-term follow-up period. No long-term effects on contraceptive practice were observed among new respondents who were not exposed to the intervention program.

Conclusions

Comprehensive community-based interventions appear to have limited long-term effects on contraceptive use among unmarried youth in suburban Shanghai. It is necessary to provide sex and reproductive health education and services to all unmarried young people on a regular basis.

Keywords: Sexually active youth, Sex education, Reproductive health services, Contraceptive use, Long-term effects, Community-based program, China