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CDC: LARC Use Up, Contraceptive Use Steady

CDC: LARC Use Up, Contraceptive Use Steady

December 12, 2014 — The percentage of women ages 15 to 44 using long-acting reversible contraceptives doubled between 2006-2010 and 2011-2013, while the overall proportion of women in that age group who used contraceptives remained steady, according to a new CDC survey, the Washington Post's "Wonkblog" reports.

LARC, including hormonal implants and intrauterine devices, have a very low failure rate, at less than 1%. By comparison, the failure rate for oral contraceptives is 9% and condoms' failure rate as a contraceptive is 18%, with typical use, according to CDC.

Key Findings: Contraceptive Use by Type

The survey found that 61.7% of women ages 15 to 44 used a form of contraception in the period from 2011 through 2013, compared with 62.2% from 2006 through 2010 (Millman, "Wonkblog," Washington Post, 12/11).

For the most recent time period, the most commonly used methods were oral contraceptives, at 16%; female sterilization, at 15.5%; and male condoms, at 9.4%. Women ages 15 to 24 were the most likely to report using oral contraceptives, at about 25%, compared with 16.9% of respondents ages 25 to 34 and 8.7% of respondents ages 35 to 44 (Rettner, Live Science, 12/11).

Meanwhile, the researchers found that the rate of LARC use increased from 3.8% to 7.2% between the two time periods.

Specifically, the survey found that 11.1% of women ages 25 to 34 and 5% of women ages 15 to 24 used LARC in the 2011 through 2013 period. According to "Wonkblog," one area that "will be important to watch" going forward is the LARC use rate among younger women, as guidelines that the American College of Obstetricians and Gynecologists issued in fall 2012 said that physicians should recommend LARC as "'first-line contraceptive options'" for adolescents who want to avoid pregnancy ("Wonkblog," Washington Post, 12/11).

Further, researchers found that IUDs were the most widely used LARC method, with 6.4% of women using IUDs between 2011 and 2013, compared with 3.5% who used IUDs between 2006 and 2010.

Key Findings: Demographic Differences

Meanwhile, the survey found that while condom use was similar across racial and ethnic groups, other contraceptive use rates varied. For example, black women had the highest rate of female sterilization at 21%, compared with 14% of white women, in the most recent time period. In addition, 19% of white women reported using oral contraceptives, compared with 11% of Hispanic women and 10% of black women.

Further, 27% of women with only a G.E.D. or high school diploma reported using female sterilization, compared with 10% of women with at least a bachelor's degree.

Reaction

According to Vanessa Cullins, Planned Parenthood Federation of America's vice president for external medical affairs, differences in health care access contribute to racial differences in contraceptive use. Cullins said, "We know that black and Hispanic women are less likely to have access to regular affordable health care, less likely to have insurance, and access to contraception is part of that." She added, "Cost is a huge barrier. When a woman has to make a choice between her birth control and feeding her kids, birth control is going to get short shrift."

Cullins continued, "This is one of the many reasons that the Affordable Care Act [PL 111-148] is so important. Because of the ACA's birth control benefit, millions more women have access to no-copay birth control, so cost is no longer a barrier."

Meanwhile, Guttmacher Institute senior research associate Laura Lindberg attributed the rise in LARC use to recent revisions in guidelines from some health care organizations. However, she noted that such methods do not prevent sexually transmitted infections, so it remains important to "continu[e] to promote and support the use of" female and male condoms, "either alone or in conjunction with a hormonal method," to reduce STI risk (Haelle, HealthDay/U.S. News & World Report, 12/11).