Contraceptive Knowledge, Substance Abuse and Unintended Pregnancy among First-Year Medical Students Attending a Public University in Mexico City

Study background: Mexico is currently undergoing an adolescent pregnancy epidemic, holding the first place in teen fertility rates among countries belonging to the Organization for Economic Development and Cooperation. The country has made significant strides with national health surveys; however there is a dearth of evidence documenting the risk factors associated with adolescent pregnancy among specific groups. Objectives: This study aims to document: knowledge, current contraceptive use and sexual practices among first-year medical students attending the largest public university in Latin America. We also measured the prevalence of unintended pregnancy and substance abuse and correlated these variables. Methods: A convenience sample of 1,388 medical students (17-19 years) responded a survey on risk factors for unintended pregnancy. We carried out a survey’s internal reliability analysis. Multivariate analysis identified variables associated with unsafe sex practices and unintended pregnancy. Results: From the 1,388 students, 26.3% were men, 365/1,388 reported current sexual activity (in the last 3 months). Of 365, 100% had heard of condoms, 71% about oral contraceptives and 76.4% considered emergency contraception an abortifacient. During their first sexual encounter, 88.2% used condoms, 3.6% used emergency contraception, 1.9% coitus interrupts, 5.8% did not use any method, 0.5% “other”. 17/230 women (7.4%) became pregnant after starting their sexual life at 15 years (SD: 1.3, 3.3 mean partners, SD: 1.7). 13/17 had an abortion without specifying type and method used. Multivariate analyses showed that being sexually active, reporting current substance abuse increased the odds of unsafe sex practices and unintended pregnancy. Conclusion: Our findings are consistent with the association of unsafe sex practices, inconsistent method use and unintended pregnancy. Our unintended pregnancy prevalence of 7.4% was lower than the national prevalence. First year medical students are primed to obtain evidence based contraceptive knowledge, correlates of unintended pregnancy, unsafe sex practices and substance abuse prevention.