Dual-Method Contraception Among Adolescents and Young People: Are Long-Acting Reversible Contraception Users Different? A Qualitative Study

Abstract

Study objective: The purpose of this study was to understand the factors and influences that affect dual-method contraception in adolescent and young adult women using long-acting reversible contraception (LARC) and whether these are unique to LARC users.

Design: Qualitative semistructured interview study.

Setting and participants: Adolescents and young women aged 14-24 years using LARC methods, adolescents and young women aged 14-24 years using short-acting reversible contraception (SARC), and men aged 14-30 years.

Interventions: Interviews were conducted until thematic saturation was reached.

Main outcome measures: The team used a grounded theory approach to identify common themes relating to dual-method contraception.

Results: Interviews were conducted with 20 LARC users, 26 SARC users, and 13 men. There were no differences in dual-method contraception use between LARC users and SARC users. Most participants used condoms primarily for pregnancy prevention rather than sexually transmitted infection (STI) prevention. Relationship context played an important role in dual-method contraception among all 3 groups; participants were less likely to use condoms in a long-term or monogamous relationship than with new or casual partners. Most participants perceived themselves to be at low risk for STI acquisition, although even those who identified themselves to be at risk did not consistently use condoms. Immediate availability of condoms was a determinant of condom use in all 3 groups, whereas knowledge, access, and negotiation of condom use were not.

Conclusion: LARC users are similar to SARC users in their decision-making about condom use. Relationship factors and STI risk assessment are important components to be included in contraceptive counseling.

Keywords: Adolescents; Dual-method contraception; LARC; Long-acting reversible contraception; Young adults.