DOI: 10.3390/adolescents6060089 ISSN: 2673-7051

Heterogeneity of Contraceptive Attitudes and Usage Patterns Among Youth in Poland: A Cross-Sectional Study

Piotr Pawłowski, Otylia Kościołek, Aneta Kościołek, Joanna Milanowska, Marzena Samardakiewicz

Reproductive behaviors and contraceptive attitudes among adolescents represent a pivotal public health challenge. Despite high subjective confidence, young individuals face increased risks of contraceptive failure and unintended pregnancy. Within the specific socio-legal framework in Poland, characterized by restricted contraceptive access, recognizing population heterogeneity is essential. This study aimed to identify latent patterns regarding information sources, expectations toward sex education curricula, and decision-making motives using a person-centered approach. A cross-sectional observational study was conducted among n = 310 participants aged 16–21 years (M = 18.09, SD = 1.51; 86.5% female). A self-developed, standardized survey assessing sexual knowledge, information acquisition, method evaluation, and contraceptive motives was administered. Latent Class Analysis (LCA) and Latent Profile Analysis (LPA) were applied using Maximum Likelihood estimation. Optimal subgroup extraction was validated using Bayesian Information Criterion (BIC) minimization, entropy indices, and Bootstrapped Likelihood Ratio Tests (BLRT). Although 98.4% of respondents declared familiarity with contraceptive methods, 50.65% reported unmet informational needs. LPA on information sources revealed 4 profiles: Mainstream Digital and Peer (74.8%), Integrated Multi-Source (10.7%), Informal Sources Exclusive (10.7%), and Internet Exclusive (3.9%). LCA on educational expectations distinguished 3 latent paradigms: Comprehensive Content (60.0%), Biomedical-Focused Content (22.6%), and Topical/Selective Topics (17.4%). Among sexually active participants (n = 123), decision-making LPA identified: Priority 1: Efficacy and Comfort (43.1%), Priority 2: Multidimensional Criteria (39.8%), and Priority 3: Unspecified or Undecided (17.1%). Short-acting user-dependent methods predominated, while long-acting reversible contraception (LARC) usage was virtually absent. Crucially, cross-tabulation revealed no significant associations among the different classification schemes (e.g., information profiles vs. decision-making motives), highlighting a disconnect between informational preparedness and actual decision-making in youth reproductive health behaviors. The identified multidimensional diversity, which primarily reflects the perspectives of young women due to sample composition, indicates that “one-size-fits-all” public health strategies are insufficient. Crucially, due to the marked sex imbalance and limited statistical power to detect gender-specific differences, these findings cannot be robustly generalized to the broader adolescent and young-adult population and require highly cautious interpretation. Implementing evidence-based Comprehensive Sexuality Education (CSE) and designing targeted, profile-adapted public health interventions are urgently required to meet the specific informational and contraceptive needs of youth.

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