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To compare long-acting reversible contraceptive (LARC) method initiation by device at time of emergency contraception (EC) request.
All clients who presented to four Planned Parenthood Association of Utah clinics for EC from February 2021 to April 2022 received printed information about three LARC options for EC in addition to oral options. LARC options included the copper T380A intrauterine device (IUD), 52 mg levonorgestrel (LNG) IUD, and the guideline-supported option for oral LNG with same-day etonogestrel (ENG) implant. Participants were aged 18–35, who reported unprotected intercourse within five days with negative pregnancy testing. We assessed demographic variables associated with method selection and reasons for method choice. LARC methods were available at no cost.
A total of 194 EC clients (18% of 1,086 approached) requested LARC and 187 qualified: 24% (n=44) selected a copper IUD, 23% (n=43) a 52 mg LNG IUD, and 54% (n=100) an ENG implant and oral LNG. ENG implant users were younger (22.9) than those selecting the LNG IUD (25.4) or copper IUD (25.9, p<0.01). Copper IUD users had a lower mean BMI (24.0) than those selecting an LNG IUD (27.0) or ENG implant and oral LNG (27.1, p=0.01). Commonly cited reasons for choosing ENG implant and oral LNG included having friends using the same method (30.0%), wanting fewer side effects (20.0%), and wanting lighter or no bleeding (18.0%).
In this observational study of EC clients desiring LARC, participants more frequently selected the ENG implant with oral LNG over either IUD, despite a lack of EC efficacy data for the ENG implant with oral LNG.
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© 2022 Published by Elsevier Inc.