Abstract
Objective To assess LARC use trends among college women (18–24 years) and identify groups that have increased LARC use. Methods Data were extracted from the National College Health Assessment-II (NCHA-II) fall 2008–2013 surveys. Logistic regression statistics were used to assess LARC use. Results Although LARC use increased from 2008 to 2013 (aOR = 2.62; 95% CI 2.23–3.07), less than half of the sample (44%) reported using contraception at last vaginal sex. Only 2.5% of college women in this study reported using a LARC method; of LARC users, 90% reported using an intrauterine device. Nearly all sociodemographic factors were significantly associated with increases in LARC use including: age, sexual orientation, and insurance status. Conclusions LARC use significantly increased among college women. However, less effective methods such as condoms and short-acting reversible contraceptives are used more frequently. Promoting LARC use for women who desire to effectively prevent pregnancy can reduce unintended pregnancy and improve health outcomes for women while in college. Future work should examine the importance of individual and lifestyle factors that influence college women’s decision to choose a LARC method and seek to eliminate barriers to college women choosing a contraceptive method they believe works best for them.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abraham, M., Zhao, Q., & Peipert, J. F. (2015). Young age, nulliparity, and continuation of long-acting reversible contraceptive methods. Obstetrics & Gynecology, 126(4), 823–829. https://doi.org/10.1097/AOG.0000000000001036.
American Academy of Pediatrics. (2014). Contraception for adolescents. Pediatrics, 134(4), e1244–e1256. https://doi.org/10.1542/peds.2014-2299.
American College Health Association. (2012). Student objectives. Retrieved January 3, 2017, from https://www.acha.org/HealthyCampus/HealthyCampus/Student_Objectives.aspx.
American College Health Association. (2014). American College Health Association—National College Health Assessment II: Reference group data report, fall 2013. Hanover, MD: American College Health Association.
American College Health Association. (2015). Spring 2015 reference group executive summary. Retrieved December 11, 2016, from http://www.acha-ncha.org/docs/NCHA-II_WEB_SPRING_2015_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf.
American College Health Association. (n.d.). American College Health Association National College Health Assessment. Retrieved December 21, 2016, from http://www.acha-ncha.org/.
American College of Obstetricians and Gynecologists. (2012). Adolescents and long-acting reversible contraception: Implants and intrauterine devices. ACOG Committee Opinion, 120(539), No. 539. https://doi.org/10.1097/AOG.0b013e3182723b7d.
Braveman, P. (2014). What is health equity: And how does a life-course approach take us further toward it? Maternal and Child Health Journal, 18(2), 366–372. https://doi.org/10.1007/s10995-013-1226-9.
Brown, M. K., Auerswald, C., Eyre, S. L., Deardorff, J., & Dehlendorf, C. (2013). Identifying counseling needs of nulliparous adolescent intrauterine contraceptive users: A qualitative approach. Journal of Adolescent Health, 52(3), 293–300. https://doi.org/10.1016/j.jadohealth.2012.07.004.
Cheng, S.-C. J., & Van Leuven, K. A. (2015). Intrauterine contraception and the facts for college health. The Journal for Nurse Practitioners, 11(4), 417–423. https://doi.org/10.1016/j.nurpra.2014.10.029.
Daniels, K., Daugherty, J., & Jones, J. (2014). Current contraceptive status among women aged 15–44: United States, 2011–2013. NCHS Data Brief, (173), 1–8. https://www.ncbi.nlm.nih.gov/pubmed/25500343.
Dehlendorf, C., Rodriguez, M. I., Levy, K., Borrero, S., & Steinauer, J. (2010). Disparities in family planning. American Journal of Obstetrics & Gynecology, 202(3), 214–220. https://doi.org/10.1016/j.ajog.2009.08.022.
Eisenberg, D., McNicholas, C., & Peipert, J. F. (2013). Cost as a barrier to long-acting reversible contraceptive (LARC) use in adolescents. The Journal of Adolescent Health, 52(4 Suppl), S59–S63. https://doi.org/10.1016/j.jadohealth.2013.01.012.
Ernst, S., Ela, E., McAndrew, L., Steele, M., Challa, S., Zowchowski, M. K., … Hall, K. S. (2015). Awareness and knowledge of long acting reversible contraception among young women on college campus. Journal of Pediatric and Adolescent Gynecology, 28(2), e62. https://doi.org/10.1016/j.jpag.2015.02.076.
Fielder, R., & Carey, M. P. (2011). Prevalence and characteristics of sexual hookups among first-semester female college students. Journal of Sex & Marital Therapy, 36(4), 1–10. https://doi.org/10.1080/0092623X.2010.488118.
Finer, L. B. (2010). Unintended pregnancy among U.S. adolescents: Accounting for sexual activity. The Journal of Adolescent Health, 47(3), 312–314. https://doi.org/10.1016/j.jadohealth.2010.02.002.
Finer, L. B., Jerman, J., & Kavanaugh, M. L. (2012). Changes in use of long-acting contraceptive methods in the United States, 2007–2009. Fertility and Sterility, 98(4), 893–897. https://doi.org/10.1016/j.fertnstert.2012.06.027.
Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84(5), 478–485. https://doi.org/10.1016/j.contraception.2011.07.013.
Finer, L. B., & Zolna, M. R. (2016). Declines in unintended pregnancy in the United States, 2008–2011. The New England Journal of Medicine, 374(9), 843–852. https://doi.org/10.1056/NEJMsa1506575.
Fleming, K. L., Sokoloff, A., & Raine, T. R. (2010). Attitudes and beliefs about the intrauterine device among teenagers and young women. Contraception, 82(2), 178–182. https://doi.org/10.1016/j.contraception.2010.02.020.
Habel, M. A., Coor, A., Beltran, O., Becasen, J., Pearson, W. S., & Dittus, P. (2018). The state of sexual health services at US colleges and universities. Journal of American College Health, 1–10.
Hall, K., Ela, E., Zochowski, M., Challa, S., McAndrew, L., Steel, M., … Ernst, S. (2015). College women’s knowledge of and perceived barriers to long-acting reversible contraceptive methods. Contraception, 92(4), 404–405. https://doi.org/10.1016/j.contraception.2015.06.198.
Hall, K. S., Ela, E., Zochowski, M. K., Caldwell, A., Moniz, M., McAndrew, L., … Ernst, S. (2016). “I don’t know enough to feel comfortable using them:” Women’s knowledge of and perceived barriers to long-acting reversible contraceptives on a college campus. Contraception, 93(6), 556–564. https://doi.org/10.1016/j.contraception.2016.02.007.
Harper, C. C., Blum, M., de Bocanegra, H. T., Darney, P. D., Speidel, J. J., Policar, M., & Drey, E. A. (2008). Challenges in translating evidence to practice: The provision of intrauterine contraception. Obstetrics & Gynecology, 111(6), 1359–1369. https://doi.org/10.1097/AOG.0b013e318173fd83.
Higgins, J. A. (2017). Pregnancy ambivalence and long-acting reversible contraceptive (LARC) use among young adult women: A qualitative study. Perspectives on Sexual and Reproductive Health. https://doi.org/10.1363/psrh.12025.
Jones, R. K., Tapales, A., Lindberg, L. D., & Frost, J. (2015). Using longitudinal data to understand changes in consistent contraceptive use. Perspectives on Sexual and Reproductive Health, 47(3), 131–139. https://doi.org/10.1363/47e4615.
Kavanaugh, M., Jerman, J., & Finer, L. (2015a). Changes in use of long-acting reversible contraceptive methods among U.S. women, 2009–2012. Obstetrics & Gynecology, 126(5), 917–927. https://doi.org/10.1097/AOG.0000000000001094.
Kavanaugh, M., Jerman, J., & Finer, L. (2015b). Who uses long-acting reversible contraceptive methods in the United States, which methods do they use and who stops using them? Contraception, 92(4), 381. https://doi.org/10.1016/j.contraception.2015.06.110.
Kelley, S. S., Borawski, E. A., Flocke, S. A., & Keen, K. J. (2003). The role of sequential and concurrent sexual relationships in the risk of sexually transmitted diseases among adolescents. Journal of Adolescent Health, 32(4), 296–305.
Martin, J. A., Hamilton, B. E., Osterman, M. J., Curtin, S. C., & Matthews, T. J. (2015). Births: Final data for 2013. National Vital Statistics Reports, 64(1). http://www.ncbi.nlm.nih.gov/pubmed/25603115.
Peipert, J. F., Zhao, Q., Allsworth, J. E., Petrosky, E., Madden, T., Eisenberg, D., & Secura, G. (2011). Continuation and satisfaction of reversible contraception. Obstetrics & Gynecology, 117(5), 1105–1113. https://doi.org/10.1097/AOG.0b013e31821188ad.
Rahn, R. N., Pruitt, B., & Goodson, P. (2016). Utilization and limitations of the American College Health Association’s National College Health Assessment instrument: A systematic review. Journal of American College Health, 64(3), 214–237. https://doi.org/10.1080/07448481.2015.1117463.
Ricketts, S., Klingler, G., & Schwalberg, R. (2014). Game change in Colorado: Widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women. Perspectives on Sexual and Reproductive Health, 46(3), 125–132. https://doi.org/10.1363/46e1714.
Rocca, C. H., & Harper, C. C. (2012). Do racial and ethnic differences in contraceptive attitudes and knowledge explain disparities in method use? Perspectives on Sexual and Reproductive Health, 44(3), 150–158. https://doi.org/10.1363/4415012.
Sundstrom, B. (2012). Fifty years on “the pill”: A qualitative analysis of nondaily contraceptive options. Contraception, 86(1), 4–11. https://doi.org/10.1016/j.contraception.2011.10.016.
Sundstrom, B., Baker-Whitcomb, A., & DeMaria, A. L. (2015). A qualitative analysis of long-acting reversible contraception. Maternal and Child Health Journal, 19(7), 1507–1514. https://doi.org/10.1007/s10995-014-1655-0.
Thompson, E. L., Vamos, C. A., Griner, S. B., Logan, R., Vázquez-Otero, C., & Daley, E. M. (2017). Sexually transmitted infection prevention with long-acting reversible contraception: Factors associated with dual use. Sexually Transmitted Diseases. https://doi.org/10.1097/OLQ.0000000000000620.
Turrisi, R., Mallett, K. A., Mastroleo, N. R., & Larimer, M. E. (2006). Heavy drinking in college students: Who is at risk and what is being done about it? The Journal of General Psychology, 133(4), 401–420. https://doi.org/10.3200/GENP.133.4.401-420.
Upadhyay, U. D., Raifman, S., & Raine-Bennett, T. (2016). Effects of relationship context on contraceptive use among young women. Contraception, 94(1), 68–73. https://doi.org/10.1016/j.contraception.2016.02.025.
Acknowledgements
The opinions, findings, and conclusions presented/reported in this article are those of the authors and are in no way meant to represent the corporate opinions, views, or policies of the American College Health Association (ACHA). ACHA does not warrant nor assume any liabilities or responsibility for the accuracy, completeness, or usefulness of any information presented in this article. This work was presented at American Academy of Health Behavior 2016 Annual Meeting.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Logan, R.G., Thompson, E.L., Vamos, C.A. et al. Is Long-Acting Reversible Contraceptive Use Increasing? Assessing Trends Among U.S. College Women, 2008–2013. Matern Child Health J 22, 1639–1646 (2018). https://doi.org/10.1007/s10995-018-2560-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2560-8