Adolescents' and Young Adults' Receipt of Person-Centered Contraceptive Counseling.

Abstract

Access to person-centered contraceptive counseling (PCCC) is critical for adolescents and young adults. There is limited data on the quality of contraceptive counseling that young people are receiving in the US. To assess the quality of contraceptive counseling received by adolescents and the association with use of a preferred method of contraception. This survey study used US population-based data from the 2022 to 2023 National Survey of Family Growth (NSFG). Participants included self-identified female respondents who had a contraceptive care visit in the past year and responded to the PCCC items. The analytic sample included 261 adolescent respondents aged 15 to 19 years, 276 young adult respondents aged 20 to 24 years, and 1506 adult respondents aged 25 years or older. Data were analyzed from December 2024 to July 2025. Receipt of PCCC and preferred contraceptive method use. Multivariable logistic regression analyses and 95% CIs were used to assess data. This study analyzed data from 2043 self-identified female respondents. The sample was nationally representative, with 12.8% (95% CI, 10.2%-15.8%) of respondents identifying as Black, 19.5% (95% CI, 15.7%-23.9%) as Hispanic, and 58.6% (95% CI, 53.8%-63.3%) as White. Additionally, 57.6% (95% CI, 53.4%-61.8%) lived above 250% of the federal poverty line, and 66.1% (95% CI, 62.7%-69.2%) received birth control services from a private doctor's office or health maintenance organizations facility. Receipt of PCCC was low across all age groups. However, adolescents aged 15 to 19 years had significantly lower odds of receiving PCCC than adults aged 25 years or older (adjusted odds ratio [aOR], 0.61; 99% CI, 0.37-0.99). There were no differences in receipt of PCCC between young adults aged 20 to 24 years and adults aged 25 years and older (aOR, 0.83; 99% CI, 0.55-1.24). Adolescents who received PCCC had significantly higher odds of using their preferred contraceptive method than adolescents who did not receive PCCC (aOR, 2.35; 95% CI, 1.06-5.21). There were no differences in preferred contraceptive method use by PCCC among young adults (aOR, 0.57; 95% CI, 0.25-1.26) or adults (aOR, 1.01; 95% CI, 0.70-1.45). In this survey study of self-identified female respondents, we found that adolescents were less likely than adults age 25 years or older to receive PCCC, but adolescents who did receive PCCC reported higher rates of preferred method use. These findings support ongoing efforts to improve the quality of contraceptive counseling for adolescents through person-centered approaches that provide comprehensive information, respect their preferences, and support their autonomy.