Adult Contraceptive Behaviour 2018

A total of 992 sexually active women and men between the ages of 18 and 49 participated in the study. The survey was conducted using computer-supported telephone interviews.

At its core the current survey is a repeat of the studies on contraceptive behaviour conducted on behalf of the BZgA in 2003, 2007 and 2011.

• The Pill and condoms remain the most important contraceptives in Germany. There is, however, a new development: condoms are becoming more significant as a contraceptive. In the previous studies the sexually active population for years proved to be very consistent in its contraceptive behaviour; the various methods always achieved roughly the same proportions. The current study found a behavioural change. The use of condoms has risen significantly (an increase of 9 percentage points compared to 2011), while the percentage of respondents using the Pill has dropped by 6 percentage points.
•  In the youngest age group this trend is at its most pronounced, with a decrease in the number of Pill users of 16 percentage points.

• Contraceptive behaviour changes over time – that is demonstrated well by the different responses given by the three different age categories.
• The group of people in their 20s (18–29-year-olds) contains the largest percentage of Pill-users (women; 56%), but also the largest percentage of condom users (58%). The dimensions of these figures already make it clear that there are respondents who double up. Condoms are used as often as the Pill as the sole contraceptive (35% / 34%). Sterilisation is not yet an option, and the coil is not very relevant (5%).
• The decreasing use of the Pill identified in the study is most strongly manifested in the 18–29-year-old age group: the drop here is one of 16 percentage points.

• The doubling up of the Pill and condoms is still widespread among the youngest age group – but not as much as in the past. Today a greater percentage of respondents said they used condoms as the sole contraceptive (35% compared to 20% in 2011); this corresponds to the percentage of respondents who solely use the Pill (34%).
• New: unlike in 2011 the focus of the 30–39-year-olds is no longer on the Pill. Using condoms for contraception exhibits the greatest increase in this age group (plus 11 percentage points). Consequently condoms and the Pill are equally important for the group of women in their 30s. However, unlike the respondents in their 20s, the respondents in their 30s still prefer the Pill over condoms as a sole contraceptive.

• The first and most important reason for choosing a contraceptive: the conviction that this method is safe and reliable. More than four in ten of the respondents who are currently using contraception raise the safety argument (42%).
• Three in ten contraceptive users highlighted that the contraceptive of their choice is simple and convenient to use (31%).
• Both justifications were also by far the most-often cited seven and eleven years ago. While the safety aspect has slightly increased (plus 4 points), ease of use remains just as popular as in 2011.
• The (low levels of) side effects took third place.
• On average respondents gave around 1.5 reasons for their choice.

• The safety of a contraceptive takes top priority for (almost) all respondents, regardless of what contraceptive they have chosen. However, to varying degrees: for respondents who are using condoms in combination with another method, the safety aspect is paramount (69 %), far ahead of practical considerations or other reasons.
• Those who just use the Pill emphasize the ease of use alongside safety – more so than those who just use condoms. Agreeability or a lack of side effects is not a major consideration for choosing the Pill; this consideration is more relevant for other contraceptives (condoms, coil).
• For respondents who exclusively use condoms, the fact that this contraceptive agrees well with them is as important as safety; ease of use only comes in close third place. However, the aspect of agreeability is expressed elsewhere too: in addition to the 27 percent who cite agreeability as a reason, there are a further 10 percent who explicitly argue against the Pill because it does not agree with them or because they have a generally negative attitude towards it. Taken together, agreeability is the most important reason for those who solely use condoms, at 37 percent.
• Those who use condoms in addition to another method say the issue of AIDS is a factor. 16 percent cite considerations about protection from STIs as a reason for making their contraceptive choice. This figure is more than among those who exclusively use condoms (8 %). However, this reason has seen losses in both groups compared to 2011 figures (minus 8 and minus 6 percentage points respectively).

• Hardly anyone feels poorly informed about the method of contraception he or she is using. Only 5 percent of respondents chose the response “less well informed”, and a mere 2 percent thought they were “poorly” informed.
• There are substantial differences between the sexes when it comes to whether the respondents consider their knowledge level to be excellent. While 71 percent of women class themselves as “very well” informed, the same is true for only 55 percent of men. However, both sexes have undergone an equal shift towards an optimal knowledge level in recent years.
• If the data are broken down by age, it turns out that young women under the age of 30 feel particularly convinced by their level of knowledge. All young women feel at least “well” informed (100%, young men under 30: 88%). The 18–29-year-olds are not, however, the age bracket that exhibits the highest percentage of respondents who are “very well” informed. That trait currently lies with the older women of 40+ (80%), who have therefore also seen the biggest increase here since the last survey (2011: 62%).

• More than half of the respondents said their own gynaecologist was the most important source of information for the contraceptive they are currently using. The internet and conversations with family members / friends take second and third place respectively, cited by around a third of the respondents.
• For women their gynaecologist is definitely their main reference person: 80 percent cite this person as their source of information. Other people or media are less significant by comparison, even though the vast majority of women also cite additional options. Women give an average of 2.0 sources of information. The more significant among them are the internet, conversations with friends and family, and reports in newspapers and magazines (all cited by at least 20 % and maximally 29 %).
• It is rare for men to have access to advice from a gynaecological surgery – consequently they cite this source of information more rarely (28 %). Instead, men obtain information from a wider range of channels. They use an average of 2.4 different sources of information.
• They are particularly interested in information from the internet (40 %) and in advice from family members and friends (40 %). School is of similar importance to male respondents (38 %).
• Age also has an influence on the respondents’ information behaviour. For the younger respondents the internet plays a bigger role: among the 18–29-year-olds around half of the respondents (48 %) cited the internet as an important source of information; in the next decade above this figure drops to just 31 percent, and among even older respondents down to 21 percent.

• The Pill remains the most commonly used contraceptive. Other hormonal methods are also being used to a small extent.
• The current survey contained three statements about hormonal contraception and the respondents were asked to indicate whether they agreed or disagreed with these statements. All three related to assessing the risks of using hormonal contraceptives such as the Pill, but were either presented with a positive or negative tone. Around half of the respondents agreed with the statement that using the Pill has negative effects on physical and mental wellbeing. At 22 percent fewer than half of respondents rejected this idea, while 28 percent exhibited an ambivalent attitude. Among women – the potential users – agreement with the statement that was critical about the Pill was even greater.
• Even among the respondents who are currently using the Pill as a contraceptive 29 percent agreed with the critical statement. Among the women this agreement is significantly higher than among the men whose partner takes the Pill (38 % vs. 20 %). While men express a stronger position and often express a concrete rejection of the statement, women using the Pill are more likely to choose one of the middle values on the scale, thereby exhibiting a certain ambivalence.
• The women who have decided to exclusively use condoms for contraception exhibit a high level of agreement with the critical statement that hormonal methods have negative effects on the user’s physical and mental wellbeing (81 %).
• Among the respondents with a migrant background the statement that is critical of hormonal methods also has an above-average level of agreement (64 %).
• When looking at the data by age group, the 18–29-year-olds exhibit the highest level of agreement with the critical statement.

• The second of the statements on hormonal contraception the respondents were presented with was deliberately positive in its tone: “It is completely fine to use the Pill or other hormonal methods over many years.” In this case rejecting the statement would mean that the respondent thinks there are concerns around taking the Pill or other hormonal methods for long periods. The rejection level here was 55 percent, meaning the majority has a critical attitude towards taking the Pill for many years. Again women are more critical here than men (rejection: 62 % compared to 48 %).
• The rejection of the statement is lower the higher the age of the respondent. Older respondents are therefore less critical about using the Pill for years. The 25–29-year-olds in particular think this is not a good thing to do at all. Respondents who are on the Pill are less critical (41 %) than those who exclusively use condoms (71 %).

• Only 33 percent of respondents think that even very young girls can use hormonal contraceptives such as the Pill without any risks.

Source: BZgA, data set 'Adult Contraceptive Behaviour' 2018