October 2, 2014 — A program that offered no-cost contraceptives to female adolescents at risk for unintended pregnancy and provided them with information on the effectiveness of long-acting reversible methods reduced teen pregnancy and abortion rates to less than 25% of nationwide levels, according to a study published Wednesday in the New England Journal of Medicine, the New York Times reports (Belluck, New York Times, 10/1).
According to the study, only about 5% of U.S. teenagers in 2009 reported using long-acting reversible contraceptives, even though such methods are "highly effective" at preventing unplanned pregnancies (Pal, "The Gupta Guide," MedPage Today, 10/1).
The study comes the same week as the American Academy of Pediatrics for the first time recommended in a policy statement that LARC be considered as a first choice for adolescents seeking contraceptives (Women's Health Policy Report, 9/29).
For the study, researchers analyzed data from 2008 to 2013 on 1,404 adolescents ages 15 to 19 who sought contraceptive services at a St. Louis clinic (Emery, Reuters, 10/1). As part of the Contraceptive CHOICE project, the teenagers received counseling on potential contraceptive methods, presented in the order of most effective to least effective. The participants completed telephone surveys for two to three years after the consultation ("The Gupta Guide," MedPage Today, 10/1).
The participants were all at risk for unintended pregnancy, as they were either sexually active or expected to be sexually active within six months (New York Times, 10/1). Nearly 75% had sexual intercourse within 30 days prior to enrolling in the study, nearly 50% had a previous unintended pregnancy and 18% said they have had at least one abortion. Meanwhile, 3% of the respondents had not been sexually active.
The study found that 72% of the participants selected an intrauterine device or implant -- LARC methods -- while 12.5% opted for oral contraceptives.
The annual pregnancy rate among study participants was 3.4%, compared with 15.85% among sexually experienced U.S. teens in the same age group in a separate survey. Meanwhile, the annual birth rate among the study participants was 1.94%, compared with 9.4% for sexually experienced teenagers nationally.
In addition, the annual abortion rate was 0.97% among participants, compared with a 4.15% national rate among sexually experienced teenagers. Overall, the program reduced pregnancy rates by 79% and abortion rates by 77% over five years.
When comparing the participants with all U.S. women ages 15 to 19 who were both sexually experienced and inexperienced, researchers found that the CHOICE project reduced pregnancy rates by 41%, birth rates by 44% and abortion rates by 34% (Reuters, 10/1).
The study also found that about two-thirds of participants who selected a LARC method were still using the method after two years ("The Gupta Guide," MedPage Today, 10/1).