Correlates of use of long-acting reversible methods of contraception among adolescent and young adult women☆

Abstract 

Background

Most pregnancies among adolescent and young adult women are unintended, and adolescent birth rates have risen. Use of long-acting reversible contraception may be an effective strategy to reduce the rate of unintended pregnancy.

Study Design

We conducted a secondary data analysis of nationally representative, cross-sectional data from the 2002 National Survey of Family Growth. Our sample included 1722 sexually active women aged 15–24 years. We used multivariable logistic regression to identify correlates of ever-use of depot-medroxyprogesterone acetate (DMPA) or the intrauterine device (IUD).

Results

One-quarter of our sample had ever used DMPA, and less than 2% had ever used the IUD. In multivariable analysis, increasing parity was associated with ever-use of DMPA (OR 2.07, 95% CI 1.55–2.77) and ever-use of the IUD (OR 4.57, 95% CI 1.60–13.03), but age and measures of socioeconomic status were not. Having ever been married (OR 5.54, 95% CI 1.23–24.82) and current cohabitation (OR 4.89, 95% CI 1.10–21.71) were associated with ever-use of the IUD. A history of an adolescent pregnancy was associated with ever-use of DMPA (OR 1.79, 95% CI 1.19–2.70) but not of the IUD.

Conclusions

While similarities exist between the correlates of use of DMPA and the IUD, we discovered important differences, some of which may reflect provider biases regarding IUD provision.

Keywords: Adolescent, Contraception, Intrauterine device (IUD), Depot-medroxyprogesterone acetate (DMPA), Contraceptive use, National Survey of Family Growth (NSFG)