title: Understanding the low uptake of long-acting reversible contraception by young women in Australia: a qualitative study.
abstract: BACKGROUND
  Australia has high rates of teenage pregnancy compared with many Western countries. Long-acting reversible contraception (LARC) offers an effective method to help decrease unintended pregnancies; however, current uptake remains low. The aim of this study was to investigate barriers to LARC use by young women in Australia.
  
  
  METHODS
  Healthcare professionals were recruited through publicly available sources and snowball sampling to complete an interview about young women's access to and use of LARC. The sample consisted of general practitioners, nurses, medical directors of reproductive and sexual health organisations, a sexual health educator, and health advocates. In addition, four focus groups about LARC were conducted with young women (aged 17-25 years) recruited via health organisations and a university. The data were analysed thematically.
  
  
  RESULTS
  Fifteen healthcare professionals were interviewed and four focus groups were conducted with 27 young women. Shared barriers identified included norms, misconceptions, bodily consequences, and LARC access issues. An additional barrier identified by young women was a perceived lack of control over hormones entering the body from LARC devices. Healthcare professionals also raised as a barrier limited confidence and support in LARC insertions. Strategies identified to increase contraceptive knowledge and access included increasing nurses' role in contraceptive provision and education, improving sex education in schools, and educating parents.
  
  
  CONCLUSIONS
  Challenges remain for young women to be able to make informed choices about contraception and easily access services. More research is needed around innovative approaches to increase LARC knowledge and access, including examining the role of nurses in enhancing young women's reproductive health.
authors.affiliation: Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. garrett@unimelb.edu.au.
authors.forename: Cameryn C
authors.initials: CC
authors.lastname: Garrett
authors.affiliation: Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. l.keogh@unimelb.edu.au.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Keogh
authors.affiliation: Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. a.kavanagh@unimelb.edu.au.
authors.forename: Anne
authors.initials: A
authors.lastname: Kavanagh
authors.affiliation: Centre for Excellence in Rural Sexual Health, Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria, Australia. jtomnay@unimelb.edu.au.
authors.forename: Jane
authors.initials: J
authors.lastname: Tomnay
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. j.hocking@unimelb.edu.au.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001315:Australia; D003267:Contraception / Q000706:statistics & numerical data*; D003271:Contraceptive Agents, Female / Q000627:therapeutic use*; D003376:Counseling; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D016912:Levonorgestrel / Q000627:therapeutic use; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control*; D049168:Pregnancy, Unplanned / Q000523:psychology; D036301:Qualitative Research
chemical_list: D003271:Contraceptive Agents, Female; D016912:Levonorgestrel