LARC and dual use in adolescents and young women
Awarded 2015
Complex Family Planning Fellowship Research
Shandhini Raidoo, MD
University of Hawaii at Manoa

Long-acting reversible contraception (LARC) such as intrauterine devices (IUDs) and implants are becoming more popular among young people, but do not protect against sexually transmitted infections, which disproportionately impact this group. The purpose of this study was to understand the factors and influences that impact dual method contraception in adolescent and young adult women using long-acting reversible contraception (LARC) and whether these are unique to LARC users.
This was a qualitative interview study of adolescents and young women aged 14-24 using LARC methods, adolescents and young women aged 14-24 using short-acting reversible contraception (SARC), and men aged 14-30. The semi-structured interview guide was based on the Theory of Planned Behavior. Interviews were conducted until thematic saturation was reached. Common themes relating to dual method contraception were identified using a grounded theory approach.
Interviews were conducted with 20 LARC users, 26 SARC users, and 13 men. There were no differences in dual method contraception use between LARC users and SARC users. Most participants used condoms primarily for pregnancy prevention rather than STI prevention. Relationship context played an important role in dual method contraception among all three groups; participants were less likely to use condoms in a long-term or monogamous relationship than with new or casual partners. Most participants perceived themselves to be at low risk for STI acquisition, although even those who identified themselves to be at risk did not consistently use condoms. Immediate availability of condoms was a determinant of condom use in all three groups, while knowledge, access, and negotiation of condom use were not.
LARC users are similar to SARC users in their decision making about condom use. Relationship factors and STI risk assessment are important components to be included in contraceptive counseling to encourage dual method use practices.

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