P081And then what happened? Assessing contraceptive use outcomes over three years among participants in the her salt lake contraceptive initiative

Abstract

<h3>Objectives</h3> The purpose of this study was to assess contraceptive outcomes over time among a population of people who had initially received no-cost contraception through a county-wide contraceptive access program. <h3>Methods</h3> We included all participants who had enrolled in the HER Salt Lake project's longitudinal study. Participants reported contraceptive outcomes in surveys at nine time points over three years. We conducted multinomial logistic regression analyses assessing predictors of each outcome (continuation, switching, discontinuation) over the study period. We also assessed patterns of discontinuation and subsequent method uptake among participants. <h3>Results</h3> At the 36-month follow-up, among 4,289 participants included in the sample, 48.5% continued their baseline method, 23.2% reported at least one period of discontinuation, and 28.2% reported switching methods at least once. Factors associated with contraceptive switching included younger age, selecting a short-acting method, clinic where the method was received and time since baseline. People planning a pregnancy within five years were less likely to discontinue than those who never wanted a pregnancy, those who were uncertain, or those who wanted pregnancy in 5–10 years. Short-acting method selection, clinic where method was received, and time since baseline also increased the likelihood of discontinuation. Among those who discontinued, 21% subsequently returned to their previous method, 28% eventually reported new method uptake, and 51% did not report a new method after discontinuing. People who discontinued injectables, pills, or vaginal rings were more likely than others to report returning to their previous method. <h3>Conclusions</h3> Change in contraceptive use is common over time, even among those who receive no-cost access.