FROM A CDC TELEBRIEFING

Despite birth rates among American teenagers continuing to decrease in recent years, not enough sexually active teens know of and use LARC, which the Centers for Disease Control and Prevention calls the most effective type of reversible birth control currently available and is highlighting in their latest Vital Signs report.

Long-acting reversible contraception (LARC) is a contraceptive method that involves using either an intrauterine device (IUD) or an implant to prevent pregnancy. The IUD comes in hormonal and copper variants; the former releases progestin in the uterus and can be effective for up to 5 years, while the latter is effective for up to 10 years. The LARC implant is a device placed into a patient’s arm, secreting progestin to stop ovulation; it lasts 3 years.

“Nearly 90% of teens used birth control the last time they had sex, [but] most teens used condoms and birth control pills, which are not always used consistently or correctly,” CDC Principal Deputy Director Ileana Arias, Ph.D. , said during a media telebriefing, stressing that LARC is entirely reversible and that studies have shown that fewer than 1% of women become pregnant in their first year of using LARC.

According to findings made by the Title X Family Planning program in a study undertaken jointly by the CDC and the Department of Health and Human Services’ Office of Population Affairs (OPA), there were more than 273,000 infants born to parents aged 15-19 years in 2013. However, more teens are abstaining from sex, and higher numbers of teens who are sexually active are using contraceptives. LARC is proving popular in certain states, particularly Colorado, where 26% of teens used it in 2013, while rates in other states ranged from less than 1% to 20%.

Nationwide, LARC usage increased from 0.4% to 7.1% between 2005 and 2013, with implants being favored more than IUDs: Of 616,148 female teens seeking contraception in 2013, 4.3% used implants and 2.8% used IUDs. LARC was more popular in older teens (aged 18-19 years) than younger teens (aged 15-17 years), with 7.6% of older teens using LARC, compared with only 6.5% of younger teens (P < .001).

Dr. Arias highlighted the need for more outreach and awareness of LARC, putting the onus on domestic health care professionals to ensure that teenagers across the nation have all the resources they need to make informed decisions about birth control. To do this, she explained, requires dispelling misconceptions and eliminating barriers that stand in the way of teens having access to LARC.

In a press release, the CDC noted that clinics have reported high upfront costs for LARC supplies, lack of training, and “misplaced concerns about the safety and appropriateness of LARC for teens” as the main obstacles standing in the way of more pervasive LARC adoption. Furthermore, teenagers themselves often know very little, if anything, about LARC, and often think they can’t use it because of their age.

“Health care professionals [can] encourage teens not to have sex and discuss the use of IUDs and implants as contraceptive options available to teens who choose to be sexually active,” Dr. Arias said in a statement. “[LARC] is safe for teens, easy to use, and very effective [and] we need to remove barriers and increase awareness, access, and availability of long-acting reversible contraception such as IUDs and implants.”

Dr. Arias’s sentiments were echoed by the American College of Obstetricians and Gynecologists, which lauded the CDC’s ongoing efforts to promote LARCs efficacy and safety to American teenagers.

“Obstetrician-gynecologists play an integral role in reducing teen pregnancy rates through increased education and access to birth control [and] we firmly believe that increased adoption of [LARC] methods can play a role in reducing unintended pregnancy,” Dr. Hal C. Lawrence, ACOG CEO and executive vice president, said in a statement. He added that, “data have demonstrated that LARC methods of birth control are just as safe and as effective when used by adolescents as adults. That’s why ACOG recommends use of LARC in its committee opinion #539 entitled, ‘Adolescents and Long-Acting Reversible Contraception: Implants and Intrauterine Devices’ ( Obstet. Gynecol. 2012;120:983-8 ).”

dchitnis@frontlinemedcom.com

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