April 9, 2015 — Teenage women in the U.S. increasingly are using long-acting reversible contraceptives, but overall LARC use in this demographic remains low, according to a recent CDC report, MedPage Today's "The Gupta Guide" reports.
Both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have recommended LARC as a first-line choice of contraception for teenagers, "The Gupta Guide" reports (Yurkiewicz, "The Gupta Guide," MedPage Today, 4/7).
For the study, researchers reviewed data on contraceptive use at clinics that receive funding under the federal Title X program. The researchers assessed contraceptive use among approximately eight million women ages 15 to 19 who visited the clinics between 2005 and 2013 (Tavernise, New York Times, 4/7).
The researchers assigned contraceptives into one of three categories based on effectiveness. According to the researchers, intrauterine devices and implants were classified as "most effective"; oral contraceptives, injectables, the contraceptive patch, the vaginal ring and diaphragms as "moderately effective"; and condoms, sponges, spermicides, fertility awareness and withdrawal as "least effective."
The researchers found that teenagers' use of the most effective forms of birth control increased while use of the moderately effective and lease effective forms of birth control decreased ("The Gupta Guide," MedPage Today, 4/7).
Specifically, the researchers found that LARC use among teenage women increased from 0.4% in 2005 to about 7% in 2013 (New York Times, 4/7). According to the study, the use of IUDs increased from 0.4% to 2.8%, while the use of implants increased from 0.04% to 4.3%. By contrast, the use of moderately effective methods decreased from 76.9% to 73.4%, and the use of the least effective methods decreased from 22.7% to 19.5%.
The study also found that LARC use varied regionally, with a rate of about 9.5% in the West, 6.4% in both the Northeast and the Midwest and 5.3% in the South. According to the researchers, Colorado reported the highest percentage of teenage LARC users, at about 25.8%, while Mississippi and Indiana reported the lowest percentages, at 0.7% and 1.5%, respectively.
Further, the researchers noted that LARC use also varied by age group, with about 7.6% of teenagers ages 18 to 19 using such methods and about 6.5% of teenagers ages 15 to 17 using them ("The Gupta Guide," MedPage Today, 4/7).
Overall, according to CDC, 90% of teenagers reported using birth control the last time they had sex (Krans, Healthline, 4/7). However, CDC said most teenagers use condoms or birth control pills as their preferred contraceptive method (Reinberg, HealthDay, 4/7).
Researchers Say Barriers Remain, Recommend Strategies
The researchers wrote that the increase in LARC use was the result of a reduction in barriers to access, but they noted that some common barriers remain. They noted that there are "unfounded concerns about safety, high upfront costs and lack of awareness about LARC" ("The Gupta Guide," MedPage Today, 4/7). In addition, they pointed out that not all providers are well trained in IUD insertion and removal (HealthDay, 4/7).
To address these barriers, the researchers recommended educating clinicians that it is safe for teenagers to use LARCs, offering contraception at reduced or no cost to teenagers and training providers in LARC insertion and contraceptive counseling ("The Gupta Guide," MedPage Today, 4/7).
Meanwhile, Ileana Arias, principle deputy director at CDC, said teenagers should "think about the most effective types of birth control, and ask their doctor or family planning counselor about [LARC] as well as about other options" (HealthDay, 4/7).