204264 Characteristics of women who choose long-acting reversible contraception: Results from the first 1,500 participants in the Contraceptive Choice Project

Monday, November 9, 2009

Meredith Ellen Pittman , Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
Tessa Madden, MD, MPH , Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
Jeffrey F. Peipert, MD, MPH , Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
Gina M. Secura, PhD, MPH , Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
OBJECTIVES: To describe women who choose long-acting reversible contraception (LARC) at enrollment and measure the association between LARC use and demographic and behavioral characteristics.

METHODS: The Contraceptive Choice Project is a prospective cohort study of 10,000 women designed to promote the use of and remove financial barriers to the most effective contraceptive methods. We compared women who chose LARC to women who chose short-term refillable methods at enrollment. Within the LARC group, we compared women who chose intrauterine contraception (IUC) to women who chose the subdermal implant. We used Poisson regression to determine characteristics associated with contraceptive choice.

RESULTS: Among the first 1,500 participants, 998 (66.5%) women chose LARC; 834 LARC users (83.6%) chose IUC. In the multivariate analysis, women who chose LARC were more likely to report a recent abortion (RR=1.17, 95% CI 1.09, 1.26), two or more lifetime sexual partners (RR=1.28, 95% CI 1.09, 1.50), having at least one child (RR=1.28, 95% CI 1.16, 1.41), or living with their partner (RR=1.20, 95% CI 1.11, 1.29). Although the majority of LARC users chose IUC, implant users were more likely to have less than a high school education (RR=1.26, 95% CI 1.11, 1.44) or be younger than 20 years (RR=1.17, 95% CI 1.01, 1.36). Education and age were not strongly correlated in LARC users (r=0.214).

CONCLUSIONS: With financial barriers removed in a diverse population, the choice between LARC and non-LARC methods appears to be associated with behavioral characteristics; whereas the choice between IUC and implants is associated with demographic characteristics.

Learning Objectives:
1. Describe long-acting reversible contraceptives. 2. Discuss the benefit of making long-acting reversible contraceptives available to women from a variety of socioeconomic groups. 3. Evaluate the impact of a woman's behavioral characteristics on her contraceptive decision making.

Keywords: Contraceptives, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: After completing three years of medical school at Washington University in Saint Louis, I took the 2008-2009 academic year to work on the Contraceptive Choice Project. As a predoctoral fellow in the School of Medicine's Clinical Research Training Center, I have received one-on-one mentoring with Dr. Gina Secura and structured course work as my research within the Contraceptive Choice Project has progressed. I am involved in enrolling participants in the project, and I contributed to collecting the data on the first 1,500 participants. I analyzed the 1,500 dataset using SAS and wrote the submitted abstract. In May of 2010 I will graduate from Washington University with both an MD degree and a Masters of Science in Clinical Investigation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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