Abstract
Purpose
Long Acting Reversible Contraceptives (LARC) have high rates of safety, satisfaction,
and continuation in adolescents and young adults (AYA). Despite this, utilization
of these methods in AYA is low. The purpose of this study was to evaluate negative
personal perceptions or beliefs of birth control and LARC and their association with
contraceptive use in AYA.
Methods
We surveyed young people (14-24) seeking care at a Title X supported adolescent reproductive
and sexual health clinic to assess negative perceptions of birth control methods with
an emphasis on LARC. We used appropriate bivariate statistics to compare those endorsing
≤3 negative perceptions with those who had >3, and logistic regression to identify
predictors of contraceptive choice.
Results
We recruited 345 participants; 337 (97.7%) completed the survey. Among respondents,
the median age was 20 (range: 14-24) years and 7.04% of participants had ever been
pregnant. The most commonly held negative perceptions were fear of device migration
or breakage causing adverse health effects and concern about effect on future fertility.
The number of negative perceptions endorsed did not differ significantly by age. However,
a greater number of negative perceptions and younger age were clinical predictors
of LARC non-use.
Conclusions
AYA have negative perceptions about LARC that are often inaccurate and may limit contraceptive
acceptability and perceived options. Engaged and respectful dialogue with AYA about
their concerns and fears is essential to provide accurate and patient centered contraceptive
counseling and to ensure that young people can make informed contraceptive choices.
Keywords
Abbreviations:
LARC (Long-Acting Reversible Contraception), IUD (Intrauterine Device), AYA (Adolescents and Young Adults)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-Acting Reversible Contraception (LARC) for Adolescent.Current Opinion in Obstetrics and Gynecology. 2012; 24: 293-298https://doi.org/10.1097/GCO.0b013e32835686d5
- Long-Acting Reversible Contraception: Implants and Intrauterine Devices.ACOG Practice Bulletin. 2011; 121
- Sexual activity and contraceptive use among teenagers in the United States, 2011-2015.National Health Statistics Report. 2017; 104: 1-23
- The Health and Social Consequences of Teenage Childbearing.Family Planning Perspectives. July 1972; 4: 45
- Multilevel Predictors of Inconsistent Condom Use Among Adolescent Mothers.American Journal of Public Health. 2009; 99 (doi: 10/2105/AJPH/2007.131870): S417-S424
- A qualitative study of contraceptive understanding among young adults.Contraception. 2012; 86: 543-550
- Knowledge and Acceptability of Long-Acting Reversible Contraception Among Adolescent Women Receiving School-Based Primary Care Services.Journal of Primary Care Community Health. 2016; 7: 165-170
- Factors Associated with Contraceptive Method Choice and Initiation in Adolescents and Young Women.Journal of Adolescent Health. 2017; 61: 454-460
- Fear of intrauterine contraception among adolescents in New York City.Contraception. 2014; 89: 446-450
- Research Electronic Data Capture (REDCap).J Biomed Inf. 2009; 42: 377-381
- Barriers and Facilitators to Adolescents’ Use of Long-Acting Reversible Contraceptives.Journal of Pediatric and Adolescent Gynecology. 2017; 30: 18-22
- Foreign objects in college bodies: young women's feelings about long-active reversible contraception (LARC).Women & Health. 2020; 60: 719-733https://doi.org/10.1080/03630242.2019.1710891
- Long-Acting Reversible Contraceptive Attitudes and Acceptability in Adolescents and Young Adults: A Key to Patient-Centered Contraceptive Counseling.Journal of Pediatric and Adolescent Gynecology. 2020; 33 (doi: 10.1016.j.jpag.2020.08.013): 673-680
- Contraception for Adolescents.Journal of Clinical Research in Pediatric Endocrinology. 2020; 12: 28-40https://doi.org/10.4274/jcrpe.galenos.2019.2019.S0003
- Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives.Journal of Pediatric and Adolescent Gynecology. 2013; 26: 86-95https://doi.org/10.1016/j.jpag.2012.10.006
- Young Women's Knowledge, Attitudes and Behaviors Related to Long-Acting Reversible Contraceptives.Women's Health Issues. 2010; 20: 394-399https://doi.org/10.1016/j.whi.2010.07.005
- A Qualitative Study of Young Women's Beliefs About Intrauterine Devices: Fear of Infertility.Journal of Midwifery and Women's Health. 2016; 61: 482-488https://doi.org/10.1111/jmwh.12425
- Politics of Reproductive Rights in 20th Century America.American History. 2017; https://doi.org/10.1093/acrefore/9780199329175.013.430
- Women or LARC First? Reproductive Autonomy and the Promotion of Long-Acting Reversible Contraceptive Methods.Perspectives on Sexual and Reproductive Health. 2014; 46: 171-175https://doi.org/10.1363/46e1614
- Attitudes and beliefs about the intrauterine device among teenagers and young women.Contraception. 2010; 82: 178-182https://doi.org/10.1016/j.contraception.2010.02.020
- Menstrual bleeding: perspectives of Brazilian women.Contraception. 2011; 84: 622-627https://doi.org/10.1016/j.contraception.2011.02.010
- Menstrual irregularity from hormonal contraception: a cause of reproductive health concerns in minority adolescent young women.Contraception. 2006; 74: 214-219https://doi.org/10.1016/j.contraception.2006.03.026
- There might be blood: a scoping review on women's responses to contraceptive-induced menstrual bleeding changes.Reproductive Health. 2018; 15: 114
- The role of the social network in contraceptive decision-making among young, African American and Latina women.Journal of Adolescent Health. 2010; 47: 374-380https://doi.org/10.1016/j.kadohealth.2010.03.014
- Young adults’ sources of contraceptive information: variations based on demographic characteristics and sexual risk behaviors.Contraception. 2015; 91: 157-163https://doi.org/10.1016/j.contraception.2014.09.012
- Contraceptive Practices of Sexually Active Adolescent Females and Barriers to Their Use of Long-Acting Reversible Contraceptives.Journal of Pediatric and Adolescent Gynecology. 2017; 30: 327
- Intrauterine Contraception Continuation in Adolescents and Young Women: A Systematic Review.Journal of Pediatric and Adolescent Gynecology. 2016; 29: 659-667https://doi.org/10.1016/j.jpag.2016.06.007
- She just told me to leave it”: Women's experiences discussing early elective IUD removal.Contraception. 2016; 94: 357-361https://doi.org/10.1016/j.contraception.2016.04.012
- Achieving cost-neutrality with long-acting reversible contraceptive methods.Contraception. 2015; 91: 49-56
- Contraception for Adolescents: Focusing on Long-Acting Reversible Contraceptives (LARC) to Improve Reproductive Health Outcomes.Current Obstetrics and Gynecology Reports. 2015; 4: 53-60https://doi.org/10.1007/s13669-015-0112-4
- It just happens”: a qualitative study exploring low-income women's perspectives on pregnancy intention and planning.Contraception. 2015; 91: 150-156
- Factors Associated with Contraceptive Method Choice and Initiation in Adolescents and Young Women.Journal of Adolescent Health. 2017; 61: 454-460
- Patient Centered Contraceptive Counseling.ACOG Committee Statement. 2022; 1
- Integrating Pregnancy Ambivalence and Effectiveness in Contraceptive Choice.Health Communications. 2017; 32: 820-827
Article info
Publication history
Accepted:
March 10,
2023
Received in revised form:
February 23,
2023
Received:
October 25,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Acknowledgements
The authors would like to acknowledge the participants of the Children's Hospital Colorado BC4U clinic as well as the clinic staff for their support. Study data were collected and managed using REDCap electronic data capture tools hosted at the University of Colorado.
1
REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing: 1) an intuitive interface for validated data entry; 2) audit trails for tracking data manipulation and export procedures; 3) automated export procedures for seamless data downloads to common statistical packages; and 4) procedures for important data from external sources. All those who have contributed significantly have been listed. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.- McNicholas C
- Peipert J.
Long-Acting Reversible Contraception (LARC) for Adolescent.
Current Opinion in Obstetrics and Gynecology. 2012; 24: 293-298https://doi.org/10.1097/GCO.0b013e32835686d5
1Harrs PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – A metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics. 2009; 42(2): 377-381.
Identification
Copyright
© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.
