Abstract | November 13, 2020

Understanding Attitudes Toward Contraception and Barriers to LARC Use in the Teenage Population

Presenting Author: Julie Zixuan Yi, BS, MS4, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, Virginia

Co-authors: Lindsey Vignali, MD, Department of Obstetrics and Gynecology, George Washington University School of Medicine, Washington, DC; Joshua Coons, BS, MS, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA; Sophie Lawrence, BS, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA; Natasha Sriraman, MD, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA

Learning Objectives

  1. Describe current beliefs and attitudes towards long-acting reversible contraceptives in patients, parents, and providers at an urban pediatrics clinic in Eastern Virginia.
  2. Identify methods to address barriers and increase LARC use in adolescents in this community.

Background: Long-acting reversible contraceptives (LARC), such as intrauterine devices (IUDs) and subdermal implants, are recommended as the first-line contraceptive for all women, including adolescents. Despite their high efficacy and safety, LARC use among sexually active teenagers remains under 6% nationally. Our study aimed to identify barriers to LARC use in adolescent patients at an urban pediatrics clinic in Eastern Virginia.

Methods: Female patients ages 13-19, parents, and providers were asked to complete self-administered surveys. Surveys included demographic questions and questions regarding beliefs and attitudes towards three contraceptive methods: oral contraceptive pills (OCPs), IUDs, and implants.

Results: A total of 144 surveys were completed by patients (n=53), parents (n=40), and providers (n=51). Among the adolescents surveyed, 15 (28%) reported being sexually active and 22 (42%) reported ever having used a contraceptive. Adolescents reported using implants (26%), condoms (9%), and OCPs (3%) as contraceptive methods. Few adolescents had general knowledge about IUDs, with 14% rating the statement “I know basic information about IUDs” to be somewhat or extremely true compared to 36% for implants and 49% for OCPs. Adolescents’ choice to use a contraceptive method was significantly correlated with perceived parental support (r>0.6) and beliefs in the method’s side effects (r>0.5). Parents were most likely to recommend OCPs (38%) to their child, followed by IUDs (23%) and implants (15%). Providers were most likely to recommend OCPs (76%), followed by implants (64%) and IUDs (44%).

Conclusions: Contraceptive preference and knowledge level varied between teen patients, parents, and providers. Although subdermal implants were the most used contraceptives among adolescents in our study, parents and health care providers surveyed recommended OCPs over LARC options. In addition, most adolescents did not know basic information about all three contraceptive methods, suggesting a need for enhanced education and provider communication regarding contraception and sexual health.

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Posted in: Women’s & Children’s Health30
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