Adolescents and Long-Acting Reversible Contraception: Lessons from Mexico

Biani Saavedra-Avendano,Blair G Darney,Blair G Darney,Maria I Rodriguez,Maria I Rodriguez,Zafiro Andrade-Romo

doi:10.1007/s10995-016-2013-1

Biani Saavedra-Avendano, Blair G Darney + Show 4 more

Open Access

https://doi.org/10.1007/s10995-016-2013-1

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Abstract

Objectives We describe current use of long acting reversible contraception LARC (tier 1), hormonal (tier 2), barrier and traditional contraceptive methods (tier 3) by adolescent women in Mexico. We test whether knowledge of contraceptive methods is associated with current use of LARC. Methods We used the 1992, 1997, 2006, 2009 and 2014 waves of a nationally representative survey (ENADID). We used information from n = 10,376 (N = 3,635,558) adolescents (15–19 years) who reported ever using any contraceptive method. We used descriptive statistics and logistic regression models to test the association of knowledge of method tiers with use of tier 1 (LARC) versus tier 2, tier 3, and no contraceptive use. Results Over time, LARC use in the overall sample was flat (21 % in 1992, 23 % in 2014; p = 0.130). Among adolescents who have had a pregnancy, LARC use has increased (24 % in 1992 to 37 % in 2014). Among adolescents who did not report a pregnancy, current LARC use has remained low (1 % in 1992 and 2 % in 2014). We found positive association between LARC use and knowledge of tier 1 methods. In the overall sample LARC use is strongly correlated with exposure to marriage compared to use of tier 2 or tier 3 methods. Discussion Among adolescents in Mexico who are currently using modern methods, LARC use is relatively high, but remains primarily tied to having had a pregnancy. Our study highlights the need to expand access to LARC methods outside the post-partum hospital setting.

Highlights

Adolescent pregnancy is a persistent global health problem [9]
Objectives We describe current use of long acting reversible contraception Long-acting reversible contraception (LARC), hormonal, barrier and traditional contraceptive methods by adolescent women in Mexico
Our study shows that LARC use in Mexico is relatively high among female adolescents who are currently using modern methods, but remains primarily tied to having had a pregnancy

Summary

Introduction

Adolescent pregnancy is a persistent global health problem [9]. Births to adolescents account for 11 % of all births worldwide, and in low- and middle-income countries (LMICs), complications from pregnancy, childbirth, and unsafe abortion are among the leading causes of morbidity and mortality among adolescent females [37]. While the total fertility rate has fallen drastically, from 6.8 in the 1950s to 2.3 by 2010, likely due to use of modern contraceptive methods [12, 34], adolescent birth rates have stagnated, leading to an increase in the proportion of total births to adolescents. Contraceptive prevalence rates among adolescents are low, contributing to the high unintended pregnancy rate among adolescents [38]. The safety and acceptability of LARC use by all women, including adolescents is well established [1, 33]. Data on current LARC use by adolescents, as well as barriers to accessing and accepting a LARC method for adolescents is needed to help guide policy, programs, and health service delivery

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