Riley J Steiner1, Karen Pazol2, Andrea Swartzendruber3, Nicole Liddon4, Michael R Kramer5, Laura M Gaydos6, Jessica M Sales7. 1. Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia. Electronic address: rsteiner@cdc.gov. 2. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, Georgia. 4. Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia. 5. Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia. 6. Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia. 7. Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, Georgia.
Abstract
PURPOSE: Long-acting reversible contraceptive (LARC) methods do not require annual clinic visits for continuation, potentially impacting receipt of recommended sexually transmitted infection (STI)/human immunodeficiency virus (HIV) services for young women. We assess service receipt among new and continuing LARC users versus moderately and less effective method users and non-contraceptors. METHODS: Using 2011-2015 National Survey of Family Growth data from sexually active women aged 15-24 years (n = 2,018), we conducted logistic comparisons of chlamydia, any STI and HIV testing, and sexual risk assessment in the past year by current contraceptive type. RESULTS: Less than half of respondents were tested for chlamydia (40.9%), any STI (47.3%), or HIV (25.9%); 66.5% had their sexual risk assessed. Differences in service receipt between new and continuing LARC users as compared with moderately effective method users were not detected in multivariable models, except that continuing LARC users were less likely to be tested for HIV (adjusted prevalence ratio [aPR] = .52, 95% confidence interval [CI] = .32-.85). New, but not continuing, LARC users were more likely than less effective method users (aPR = 1.35, 95% CI = 1.03-1.76) and non-contraceptors (aPR = 1.43, 95% CI = 1.11-1.85) to have their sexual risk assessed, although both groups were more likely than non-contraceptors to be tested for chlamydia (new: aPR = 1.52, 95% CI = 1.08-2.15; continuing: aPR = 1.69, 95% CI = 1.24-2.29). CONCLUSIONS: We found little evidence that LARC use was associated with lower prevalence of STI testing. However, new, but not continuing, LARC users, as compared with those not using a method requiring a clinic visit, were more likely to have had their risk assessed, suggesting that initiating LARC may offer an opportunity to receive services that does not persist. Published by Elsevier Inc.
PURPOSE: Long-acting reversible contraceptive (LARC) methods do not require annual clinic visits for continuation, potentially impacting receipt of recommended sexually transmitted infection (STI)/human immunodeficiency virus (HIV) services for young women. We assess service receipt among new and continuing LARC users versus moderately and less effective method users and non-contraceptors. METHODS: Using 2011-2015 National Survey of Family Growth data from sexually active women aged 15-24 years (n = 2,018), we conducted logistic comparisons of chlamydia, any STI and HIV testing, and sexual risk assessment in the past year by current contraceptive type. RESULTS: Less than half of respondents were tested for chlamydia (40.9%), any STI (47.3%), or HIV (25.9%); 66.5% had their sexual risk assessed. Differences in service receipt between new and continuing LARC users as compared with moderately effective method users were not detected in multivariable models, except that continuing LARC users were less likely to be tested for HIV (adjusted prevalence ratio [aPR] = .52, 95% confidence interval [CI] = .32-.85). New, but not continuing, LARC users were more likely than less effective method users (aPR = 1.35, 95% CI = 1.03-1.76) and non-contraceptors (aPR = 1.43, 95% CI = 1.11-1.85) to have their sexual risk assessed, although both groups were more likely than non-contraceptors to be tested for chlamydia (new: aPR = 1.52, 95% CI = 1.08-2.15; continuing: aPR = 1.69, 95% CI = 1.24-2.29). CONCLUSIONS: We found little evidence that LARC use was associated with lower prevalence of STI testing. However, new, but not continuing, LARC users, as compared with those not using a method requiring a clinic visit, were more likely to have had their risk assessed, suggesting that initiating LARC may offer an opportunity to receive services that does not persist. Published by Elsevier Inc.
Entities:
Keywords:
HIV testing; Long-acting reversible contraception; STI testing
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