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Purpose: Policy and reproductive health practice changes in the past decade have affected use of different contraceptive methods, but no study has assessed contraceptive method use over this time by rural-urban residence in the United States., Methods: We used female and male respondent data (2006-2017) from the National Survey of Family Growth (n = 29,133 women and n = 24,364 men) to estimate contraceptive method use by rural-urban residence over time and contraceptive method use by age, marital status, and parity/number of children., Results: From 2006-2010 to 2013-2017, among urban women, we found increased use of two or more methods (11% to 14%); increased use of intrauterine devices (5% to 11%), implants (0 to 2%), and withdrawal (5 to 8%); and decreased use of sterilization (28% to 22%) and pills (26% to 22%). Among rural women, we found increased use of intrauterine devices (5% to 9%) and implants (1% to 5%). We found increased withdrawal use for urban men, but otherwise no differences among men across time. In data pooled across all survey periods (2006-2017), contraceptive method use varied by rural-urban residence across age, marital status, and parity/number of children., Conclusions: In a nationally representative sample of reproductive age women and men, we found rural-urban differences in contraceptive method use from 2006-2010 to 2013-2017. Describing contraceptive use differences by rural-urban residence is necessary for tailoring reproductive health services to populations appropriately., (Copyright © 2020 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)

Background: Previous studies have examined timing of sexual initiation in the United States, but little is known about rural-urban differences in age at first sex., Methods: We used female respondent data from the National Survey of Family Growth (n = 29,133; 2006-2010 and 2011-2017) to examine age at first vaginal sex with a male partner. We used the Kaplan-Meier estimator and Cox proportional hazard analyses to assess differences in age at first sex by rural-urban residence, overall and stratified by 5-year birth cohorts (1968-1997). Models were adjusted for respondent characteristics and accounted for complex survey design., Results: Overall, rural women experienced first sex earlier compared with urban women (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.12-1.29). By age 18, 62% of rural women had experienced first sex, compared with 54% of urban women. After adjustment for respondent characteristics, HRs were attenuated, but rural women were still more likely to have experienced first sex compared with urban women (HR, 1.07; 95% CI, 1.01-1.13). In unadjusted models, rural women were more likely to have experienced first sex compared with urban women for most birth cohorts (HRs ranged from 1.14 to 1.32); for only one cohort (1988-1992) was this association found in the adjusted analysis (HR, 1.23; 95% CI, 1.09-1.39)., Conclusions: Women living in rural areas were generally more likely to report first sex at an earlier age compared with urban women, suggesting that delivery of sexual education and reproductive health services for women in the United States may need to take into account rural-urban residence., (Copyright © 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)