Changes between choice of contraceptive methods before abortion and contraceptive intentions after abortion were assessed among 482 adolescents with regards to efficacy to prevent pregnancy or sexually transmitted diseases (STD) and human immunodeficiency virus (HIV). Adolescents substantially increased their intention to use oral contraceptives (214 of 452 who did not use before intended to after; p < .001) and depot-medroxyprogesterone acetate (DMPA) (121 of 469 who did not use before chose to after; p < .001). None of the 134 adolescents who used condoms as their primary contraceptive method before abortion intended to continue afterwards (p < .001). There was no difference in intention to use condoms after abortion among adolescents who received voluntary HIV counseling and testing compared to those who did not. Twenty-two percent of adolescents intended to use condoms together with spermicidal foam as their primary contraceptive method after abortion, thereby combining contraceptive efficacy with STD prevention. The intention to preferentially adopt hormonal methods as the primary contraceptive, especially among adolescents counseled and tested for HIV, is discouraging for STD and HIV prevention efforts in this adolescent population.