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Long-acting reversible contraception counseling needed for young women

Variable knowledge of long-acting, reversible contraceptives among adolescent women in school-based primary care centers suggests that more counseling and education is needed, particularly for women from diverse cultural backgrounds and those with less sexual experience, according to data published in the Journal of Primary Care and Community Health.

“Adolescent pregnancy rates have declined in the United States, yet they remain higher than in most comparable, high-income countries,” Andrea J. Hoopes, MD, MPH, of the University of Colorado Denver School of Medicine, and colleagues wrote. “More than 600,000 adolescent pregnancies annually result in a teen birth rate of 26.5 per 1,000 adolescent women aged 15 to 19 years. The majority of these pregnancies are unintended, and socioeconomically disadvantaged and minority youth are disproportionately represented in these statistics.”

To determine the correlates of knowledge and acceptability regarding long-acting, reversible contraceptives (LARC) among adolescent women in school-based health centers, the researchers conducted a cross-sectional study, including 102 female students, aged 14 through 19 years, at two locations in Seattle. The participants completed an electronic survey regarding sexual and reproductive health.

Primary outcomes included LARC knowledge, measured by correct answers to 10 true-or-false questions including in the survey, and LARC acceptability, measured by self-reported positive attitudes toward the idea of using an intrauterine device (IUD) or current use.

According to the researchers, 53 of the participants reported a history of vaginal sex. Greater LARC knowledge was associated with white race (regression coefficient = 26.8; 95% CI, 13.3-40.4; P < .001), history of vaginal intercourse (regression coefficient = 29.9; 95% CI, 17.1-42.7; P < .001) and current or prior LARC use (regression coefficient = 22.8; 95% CI, 6.5-40.; P < .007). Older age was associated with lower IUD acceptability (OR = 0.53; 95% CI, 0.3-0.94; P = .029), while history of intercourse was associated with greater acceptability (OR = 5.66; 95% CI, 1.46-22; P = .012).

“Adolescents in this school-based primary care setting had variable knowledge and acceptability of LARC methods,” Hoopes and colleagues wrote. “When adjusting for other factors, a history of vaginal intercourse was the strongest correlate of LARC method acceptability. Efforts to identify unique counseling and education needs of young women from diverse cultural backgrounds and those reporting sexual activity exclusive of vaginal intercourse may be needed.” – by Jason Laday

Disclosure: The researchers report no relevant financial disclosures.