# Sexual knowledge and contraceptive use in adolescents with type 1 diabetes in comparison with their healthy peers

## TL;DR

Adolescents with type 1 diabetes are more likely to use no protection during sex compared to healthy peers, highlighting the need for better sexual education and counseling.

## Contribution

The study compares contraceptive behaviors and sexual knowledge between adolescents with type 1 diabetes and healthy controls.

## Key findings

- 23.5% of adolescents with type 1 diabetes used no protection during their last sexual contact, compared to 10.2% of healthy controls.
- Dual protection (≥2 contraceptive methods) was more common in younger adolescents and those with older age at sexual debut.
- Family structure influenced contraceptive use in controls, with married parents associated with higher dual protection rates.

## Abstract

Adolescents with type 1 diabetes mellitus (T1D) may differ from their healthy peers in respect to sexually transmitted diseases (STDs) knowledge and contraceptive use. We aimed to explore sexual knowledge and contraceptive use and associated factors in T1D adolescents compared to healthy peers.

Fifty- eight T1D adolescents (mean ± SD age 16.3 ± 2.0 years, disease duration 6.7 ± 3.5 years) were compared to 116 healthy controls (matching 1:2 for school, age and gender). Anonymous questionnaires were used to evaluate sexual knowledge and contraceptive methods.

The commonest contraceptive method at the last sexual contact was the condom. The use of birth pill was reported by 11.8% patients and by 8.3% controls, withdrawal was reported by 33.3% of T1D and 24% of controls, no protection by 23.5% patients and by 10.2% controls, while double protection (≥2 methods) was reported by 35% patients and 27.7% controls. No study participant used long-acting reversible contraception (LARC). The high protection (dual protection) group was characterized by younger age and older age at sexual debut (16.4 vs 15.8 years, p = 0.010). The low protection group (no contraception/withdrawal) was characterized by older patients’ age (p = 0.023) and younger paternal age (p = 0.046). Among controls, the use of dual protection was more common in the group whose parents were married versus those with divorced parents (34.3 vs. 10%, p = 0.042).

Among the study population, the condom was the commonest contraceptive method for both groups, while 23.5% of patients and 10.2% controls used no protection. The degree of contraception use among patients was associated with patients’ age and parental age and with the family structure in controls. The above underline the necessity for health care professionals to provide sexual education and contraception counseling to young adolescents with T1D and their healthy peers.