Adolescents and Long-Acting Reversible Contraception: Lessons from Mexico

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.

Use of long‐acting reversible contraception in a cluster‐random sample of female sex workers in Kenya

“…Studies examining LARC use in non-sex-worker populations have rarely found a clear association with age, 23,24 and have reported mixed results regarding education. 23,26 Knowledge and positive attitude to family planning were correlates of LARC use, consistent with findings in other populations. 26 Social norms and contraceptive self-efficacy may lie on the same causal pathway as positive attitude, or may measure the same underlying construct.…”

“…23,26 Knowledge and positive attitude to family planning were correlates of LARC use, consistent with findings in other populations. 26 Social norms and contraceptive self-efficacy may lie on the same causal pathway as positive attitude, or may measure the same underlying construct. Education about LARCs has been found to improve attitude and uptake.…”

“…21 Unexpectedly, younger age and lower education were independently associated with LARC use. 26 Social norms and contraceptive self-efficacy may lie on the same causal pathway as positive attitude, or may measure the same underlying construct. 24 An association between use of any contraceptive by FSWs and older age has been T A B L E 2 Contraceptive use characteristics of the sample population.…”

Factors associated with unmet need for contraception in Mexico: evidence from the National Survey of Demographic Dynamics 2014

“…Recent estimates indicate that in Mexico 38 out of 1000 women of reproductive age have had clandestine abortions as a result of not having the necessary contraceptive methods [19]. Inconsistent use of contraceptives is also a problem experienced by young women [20]. The second most significant variable was marital status, where women never in union had a much greater unmet need for contraception than women currently in union.…”

La transición de los Objetivos de Desarrollo del Milenio a los Objetivos de Desarrollo Sostenible desde la perspectiva de los determinantes sociales de la salud y la equidad en salud

“…Se perciben supuestas barreras legales, relacionadas con el consentimiento informado, la autorización de los padres, etc., pero también existen mitos y barreras técnicas, sobre todo en relación con su uso en adolescentes nulíparas (desconocimiento de los criterios internacionales y nacionales de elegibilidad). Evidencias en este sentido pueden observarse en el acceso diferencial a los LARC que tienen las adolescentes, antes o después de un primer embarazo a término, en las diferentes instituciones del sector salud nacional 40 . Es posible, por lo tanto, que la distribución actual de los anticonceptivos utilizados por la población adolescente en México refleje no tanto las barreras, los mitos y los desconocimientos sobre ellos mismos, sino también las barreras y los sesgos radicados en los proveedores de los servicios de salud.…”