LARC use by teen girls increasing but still low

More adolescent girls are using long-acting reversible contraception (LARC)-intrauterine devices (IUDs) and implants-although the rate of use remains low among girls aged 15 to 19 years, according to a new report from the Centers for Disease Control and Prevention (CDC).

To explore LARC use among teenaged girls, researchers from the CDC and the US Department of Health and Human Services’ Office of Population Affairs analyzed 2005-2013 data from the Title X National Family Planning Program, which provides family planning and related preventive health services for low-income patients. The program serves around 1 million teenagers annually.

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Between 2005 and 2013, LARC use by the 7.5 million girls aged 15 to 19 years who sought contraceptive services at Title X sites increased from 0.4% to 7.1%. During the same period, the percentage of teenagers who used moderately effective contraceptive methods dropped from 76.9% to 73.4% and the percentage who used the least effective methods decreased from 22.7% to 19.5%. Long-acting reversible contraception is considered the most effective method for teenaged girls.

More girls aged 18 and 19 years used LARC than girls aged 15 to 17 years. Between 2005 and 2013, use increased from 0.6% to 7.6% among 18- and 19-year-olds and from 0.3% to 6.5% among 15- to 17-year-olds.

In 2013, 2.8% of the 616,148 girls who sought contraception opted for IUDs whereas 4.3% chose implants. Although IUDs were more common between 2005 and 2011, implants surpassed them in 2012 and 2013.

The percentage of teenaged LARC users varied markedly from state to state in 2013, from a low of 0.7% in Mississippi to a high of 25.8% in Colorado. The use of LARC was highest in the West at 9.5% and lowest in the South at 5.3%. The Northeast and Midwest both had usage rates of 6.4%.

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The use of LARC also varied by the type of facility. The highest rates of use by teenagers were found at Title X sites that focused on family planning services rather than primary care followed by health departments, other types of sites, and federally qualified health centers.

Efforts to improve teenagers’ access to LARC at Title X sites have increased its use more than 15-fold, especially the use of implants, although nationwide rates remain low at under 5%, the researchers conclude. In light of LARC’s efficacy, safety, and ease of use, the CDC urges continued efforts to expand access and availability to adolescents.