Purpose To describe the Intrauterine Contraception (IUC) adoption process among nulliparous adolescents and to identify the role of the medical provider in this trajectory. Methods We conducted semi-structured interviews with a clinic-based sample of twenty nulliparous adolescents (ages 15-24 years) with a history of IUC use. Interviews were analyzed using modified grounded theory and cross-case analysis to reveal a process model for IUC adoption with a focus on the role of the medical provider. Results The model includes the following stages: awareness, initial reaction, information gathering, adoption, and adjustment and reassessment. It is influenced by personal preferences and experiences, friends, family, sexual partner(s), and medical providers. Interactions with medical providers that study participants found helpful in navigating the adoption process included the use of visuals; tailored counseling to address specific contraceptive needs; assurance that IUC discontinuation was an option; information on a wide range of side effects; medical provider self-disclosure regarding use of IUC; and addressing and validating concerns both before and after IUC insertion. Conclusions Nulliparous adolescents in this study described a complex IUC adoption process in which the medical provider plays a substantial supportive role. Findings from this study may be used to counsel and support future nulliparous adolescents regarding IUC use. Implications and Contribution Summary Little is known about nulliparous adolescent use of IUC and the counseling needs of this population. This study offers counseling suggestions for medical providers that they may use to support nulliparous adolescents as they make decisions about IUC use.

structured tool. We targeted two types of venues -venues capturing "community" risk adolescents (i.e. that of typical neighborhood adolescent males) and venues capturing adolescent males who may be at higher STI risk. At each venue, males ages 14-17 were invited to participate in a computer survey of lifetime and recent sexual behaviors, risk behaviors, and STI history, as well as provide a urine sample and an optional anal swab for Chlamydia, Gonorrhea, and Trichomonas DNA-based testing. Descriptive statistics are provided. Results: We enrolled 171 participants at 17 venues (9 parks , 2 apartment complexes and 6 community events). Two participants identified as transgender, the average age was 15.7 ϩ/Ϫ 1.2, and ethnicity was 69.6% African American, 9.9% Latino and 18.8% white. We observed high rates of sexual experience and STI risk behaviors. Lifetime sexual experience included giving oral sex (36.9%), receiving oral sex ( 61.7%), vaginal (68.5%), giving anal sex (17.6%) and receiving anal sex (8.3%). 55.2% of sexually active males had more than two lifetime sex partners. Condom use was more frequent with vaginal sex, compared to oral and anal sex (30.7% always use condom with vaginal sex, 10.4% with oral sex, 7.1% with anal sex, pϽ.05). Other risk behaviors, such as marijuana use (19.9%), drug use (6.8%) and alcohol use (17.2%) before last sexual encounter, and getting someone pregnant (17, 9.9%) were also common. History of STI testing and diagnoses were uncommon (20.3% report ever being tested, 2.3% ever being told they have an STI). Four (2.4%) were infected with Chlamydia. Conclusions: Venue-based sampling is a mechanism for recruiting and enrolling adolescent males with high STI risk behaviors in community settings. Our high participation rate suggests it is an acceptable and feasible alternative to clinic, school, and other institutionalbased recruitment strategies for STI research. Its community focus makes it ideal for understanding community risk and informing screening and STI prevention interventions.