Most teenage boys who don't plan to cause pregnancy still believe it is likely they will get someone pregnant within six months

Most teenage boys who don't plan to cause pregnancy still believe it is likely they will get someone pregnant within six months. The likelihood is linked to beliefs about pregnancy and condoms, as well as socioeconomic status. These findings are reported in the electronic edition of the September issue of Pediatrics.

Despite playing an influential role in whether girls become pregnant and keep their babies, males are often overlooked in efforts to understand the motives behind teen pregnancy. This study found that attempts to prevent teenage pregnancy should involve posing questions to male adolescents to determine beliefs and attitudes that may unintentionally lead to pregnancy.

"Clearly, if you ask a teenage boy if he plans on pregnancy, he will probably say no," says lead author Cynthia Rosengard, PhD, a researcher in internal medicine at Rhode Island Hospital and an assistant professor of medicine at Brown Medical School. "But just because he doesn't plan to get someone pregnant, that doesn't mean he won't. In order to address teenage pregnancy, we need to ask the questions in different ways."

The study was conducted with 101 sexually active teenage boys, ages 14 to 19, from a California urban clinic for sexually transmitted diseases. The boys were asked about their plans to get someone pregnant compared to the likelihood that they would get someone pregnant. They were also asked about their mother's education levels, an indicator of socioeconomic status. Researchers found that while the majority of males reported that they had no plans for pregnancy, more than half said there was some likelihood they would get a girl pregnant in the next six months. Boys with a lower socioeconomic status were more likely to intend to cause a pregnancy. And those who planned to get someone pregnant held both more negative views toward condom use and more favorable views toward pregnancy.

Researchers found that boys who have inconsistent views don't necessarily want to get someone pregnant, but they may lack motivation to avoid pregnancy.

"Teenage boys feel, for a variety of reasons, that they're not always going to protect themselves against pregnancy," Rosengard says. "Some are worried their partner might not trust them if they use condoms - they might fear they're unfaithful, for example. If you find out what their intentions are, you may be able to prevent them from causing a pregnancy."

Most studies on adolescent pregnancy have focused solely on girls' attitudes, intentions and behaviors. However, male partners play a role in determining the frequency of sexual intercourse and contraceptive use. And they exert a strong influence on females' intentions to conceive, as well as their decisions regarding terminating the pregnancy. Understanding male motivations for getting someone pregnant may aid in efforts to reduce teen pregnancy, the authors write.

Rosengard previously conducted a similar study with teenage girls and found that girls also responded differently to questions about plans to become pregnant versus the likelihood of becoming pregnant. In that study, their responses to similar questions were also associated with attitudes and intentions regarding contraceptive use, as well as their reported use, and their beliefs about pregnancy.

"The difference is that boys often determine, by their views about condoms and pregnancy, whether the girl will get pregnant," Rosengard says. "If the male partner has negative views about pregnancy, he is more likely to use condoms. Likewise, if he believes that using condoms erodes trust in a relationship, he is less likely to use them, and potentially more likely to cause a pregnancy."

The findings suggest that healthcare providers, and perhaps parents, should initiate conversations about reproductive issues with adolescent males, a discussion that is typically reserved for females, Rosengard says. And those discussions could best be targeted to adolescent males whose mothers have a lower educational attainment, as well as younger adolescents - who tended to report more inconsistent pregnancy intentions.

"It wouldn't have to be a lengthy discussion," she says. "It could focus on asking a couple of questions, and tailoring messages to the responses. You could have a conversation about condoms to try to change the way a teen views them, or you could talk about preparing for a healthy pregnancy. The important point is to start addressing the issue of teen pregnancy not just with girls, but with their male partners."

The study was conducted by researchers at Rhode Island Hospital and Brown Medical School; Women & Infants Hospital; the University of California, San Francisco; and Johns Hopkins School of Medicine.