title: Characteristics of Kenyan women in a prospective cohort study who continue using subdermal contraceptive implants at 12 months.
abstract: OBJECTIVE
  Subdermal contraceptive implant continuation has not been well studied in Africa. We conducted a secondary data analysis to compare baseline characteristics of Kenyan women who continued to use the subdermal implant at 12 months to those who did not.
  
  
  METHODS
  Kenyan women aged 18-24 years who presented to a family planning clinic for short-acting hormonal contraception were offered a two-rod subdermal implant instead. Participants were followed for 12 months after initiation of their contraceptive method. Statistical analysis included Pearson's chi-square or Fisher's exact tests for comparisons of proportions. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to determine factors associated with continuation.
  
  
  RESULTS
  Eighty-six (89%) of the 97 women who chose the implant were followed for 12 months. Of these women, 68 (79%) continued to use the implant. None of the factors we examined had a statistically significant association with continued use of the implant. Duration of intended use was the only strong factor; 83% of women with 3+ years of need continued using the implant, compared to 56% of those with shorter needs (Risk ratio = 1.48, 95% CI = 0.94-2.31). No substantive continuation differences were found when comparing other participant characteristics including months with their current partner, personal desire and partner preference for future children, previous use of modern birth control and other factors.
  
  
  CONCLUSIONS
  High implant continuation rates were noted regardless of previous use of modern birth control, partner preference for children or baseline concern for menstrual change.
  
  
  CONCLUSIONS
  Contraceptive use in Africa continues to focus on short-acting contraceptives despite the proven superior efficacy of long-acting reversible contraceptives in other settings. The high subdermal implant continuation among Kenyan women in this prospective study, regardless of baseline characteristics, supports the need for increasing access and future research in this population.
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. Electronic address: oneill.erica@gmail.com.
authors.forename: Erica
authors.initials: E
authors.lastname: O'Neill
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Garrett
authors.affiliation: Family Health International 360, Durham, NC, USA.
authors.forename: David
authors.initials: D
authors.lastname: Hubacher
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D004343:Drug Implants; D005193:Family Planning Services; D005260:Female; D006801:Humans; D007630:Kenya; D016912:Levonorgestrel / Q000008:administration & dosage; D017533:Marital Status; D017060:Patient Satisfaction; D011446:Prospective Studies; D012747:Sexual Partners; D055815:Young Adult
chemical_list: D003271:Contraceptive Agents, Female; D004343:Drug Implants; D016912:Levonorgestrel
keywords: Africa; Continuation; Long-acting reversible contraceptives; Unintended pregnancy; Young women