Trends in contraceptive use among Florida women: implications for policies and programs.

Our study objective was to assess changes in effective contraceptive use among women at risk of unintended pregnancy in Florida in 2008 and 2009 compared with 2002 and 2004. Contraceptive use questions were available from Florida's Behavioral Risk Factor Surveillance System (BRFSS) for both periods (n = 4,606). Log binomial regression was used with appropriate methods to account for complex sampling in the BRFSS. We examined the change in four effective contraceptive use groups: sterilization, long-acting reversible contraceptive (LARC), short-acting reversible contraceptive (SARC), and barrier methods. Prevalence ratios comparing the two time periods were adjusted by demographic characteristics, employment, insurance status, children at home, poverty level, health behaviors, and health status. No evidence of change was found in sterilization (Adjusted Prevalence Ratio APR = 0.96; 95 % CI: 0.84-1.10) or SARC (APR = 1.01; 95 % CI: 0.87-1.18). The overall use of LARC increased and use of barrier methods decreased significantly over the two periods (APR = 1.68; 95 % CI: 1.09-2.60 and APR = 0.77; 95 % CI: 0.61-0.98, respectively). Only two population groups experienced significant changes in prevalence in the four use groups over this period. Non-Hispanic White women increased their use of LARC (APR = 2.89; 95 % CI: 1.58-5.29) and women who have never been married decreased their use of barrier methods (APR = 0.51; 95 % CI: 0.33-0.77). Contraceptive use in Florida continues to be low overall with some shift towards more effective long-term methods. New efforts are needed to promote and increase family planning practices, which include the use of effective contraceptives.