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Background: Long-acting reversible contraception (LARC) is highly effective for pregnancy prevention. However, LARC users may not receive recommended sexually transmitted disease (STD) prevention and treatment services given that LARC methods do not require annual clinic visits for continuation like many moderately effective methods. We compared STD screening between LARC users and young women using other methods.
Methods: We analyzed data from the 2011-2013 National Survey of Family Growth. Based on calendar history data, sexually-active females aged 15-24 years currently using contraception (n=804) were categorized as new LARC (initiated ≤12 months ago) or continuing LARC users (initiated >12 months ago), or users of moderately effective (pill, patch, ring, injectables), or less effective methods (condoms, withdrawal, diaphragm, rhythm). Outcomes included self-reported chlamydia and other STD testing in the prior 12 months. We examined associations between contraceptive type and testing using chi-squares and logistic regression models controlling for race/ethnicity and age.
Results: Chlamydia testing was reported by 55.1% of new LARC, 45.3% of moderately effective, 44.4% of continuing LARC, and 33.7% of less effective method users (p=.104). Other STD testing was reported by 64.2% of new LARC, 47.6% of moderately effective, 43.6% of continuing LARC, and 37.2% of less effective method users (p=.067). We found no significant differences in chlamydia (AOR=0.95, 95%CI=0.49-1.85) or other STD testing (AOR=0.81, 95%CI=0.45-1.44) comparing continuing LARC to moderately effective method users. There were no differences in chlamydia (AOR=1.21, 95%, CI=0.46-3.20) or other testing (AOR=1.61, 95%CI=0.61-4.26) comparing new LARC to moderately effective method users.
Conclusions: Low STD testing among contraceptive users is concerning, particularly given that new LARC and moderately effective method users are engaged in care for contraception. Although it is promising that testing among continuing LARC users was not lower than moderately effective method users, ongoing attention to STD screening is needed as adolescent LARC use increases.