Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women

BACKGROUND: The role of unintended pregnancy norms and stigma in contraceptive use among young women is understudied. This study investigated relationships between anticipated reactions from others, perceived stigma, and endorsed stigma concerning unintended pregnancy, with any and dual contraceptive use in this population. METHODS: From November 2014 to October 2015, young women aged 18–24 years (n=390) and at risk for unintended pregnancy and sexually transmitted infections participated in a survey at a university and public health clinics in Alabama. Multivariable regression models examined associations of unintended pregnancy norms and stigma with contraceptive use, adjusted for demographic and psychosocial characteristics. RESULTS: Compared to nonusers, more any and dual method users, were White, nulliparous, and from the university and had higher income. In adjusted models, anticipated disapproval of unintended pregnancy by close others was associated with greater contraceptive use (adjusted Odds Ratio [aOR]=1.54, 95% confidence interval [CI]=1.03–2.30), and endorsement of stigma concerning unintended pregnancy was associated with lower odds of dual method use (aOR=0.71, 95% CI=0.51–1.00). CONCLUSION: Unintended pregnancy norms and stigma were associated with contraceptive behavior among young women in Alabama. Findings suggest the potential to promote effective contraceptive use in this population by leveraging close relationships and addressing endorsed stigma.