Gender, Autonomy, and Contraceptive Use Among Young People

Investigator: Ushma Upadhyay, PhD, MPH
Sponsor: NIH National Institute of Child Health and Human Development

Location(s): United States


 In the United States, over 1.7 million young women ages 15 to 24 have an unintended pregnancy each year, leading to a range of negative health outcomes. The knowledge gained from this study will be used to guide potential interventions to reduce disparities in unintended pregnancy and help achieve the Healthy People 2020 goal of reducing the adolescent pregnancy rate by 10%.

The overall objective of this study is to conduct mentored research that examines the pathways between power, gender norms, and masculinities and contraceptive use among young people ages 15 to 24. My main hypothesis is that adherence to gender norms and traditional norms of masculinity lead to inconsistent and non-use of contraceptives. This research will assess this hypothesis through three specific aims.
Aim 1 is to explore the role that relationship power, gender norms, and masculinities have in influencing adolescent and young people's contraceptive use. This aim involves qualitative in-depth interviews with adolescent and young women, men, and couples.
Aim 2 is to adapt and validate existing instruments that measure relationship power, gender norms, and masculinities so that they are appropriate for adolescents and young people. This aim involves adapting my own Reproductive Autonomy Scale, the Gender Relations Scale, and the Masculinity Ideology in Relationships Scale for use among adolescents and young men and women.
Aim 3 is to determine how relationship power, gender norms, and masculinities impact adolescent and young people's contraceptive use through a 3-month pilot prospective study at an adolescent family planning clinic. Examining gender-based power from the perspectives of multiple disciplines using mixed-methods, I expect to make important contributions in three areas:
1) theory on gender and power and contraceptive use,
2) measurement of gender-based power among adolescents, and
3) potential interventions that reduce unintended pregnancy. Ultimately, this mentored research will prepare me for the successful submission of an R01 application to test an adolescent contraceptive use intervention and a research career in gender and power-related determinants of adolescent reproductive health.