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


METHODS
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.
Whitaker
Amy K
AK
Department of Obstetrics and Gynecology, University of Chicago Medical Center, Chicago, IL 60637, USA. awhitaker@babies.bsd.uchicago.edu
Dude
Annie M
AM
Neustadt
Amy
A
Gilliam
Melissa L
ML
D000293:Adolescent; D003267:Contraception / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage*; D015999:Multivariate Analysis; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D049168:Pregnancy, Unplanned; D014481:United States; D055815:Young Adult
D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate