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Background: Use of long-acting reversible contraception (LARC), specifically IUDs and implants, is becoming increasingly common among reproductive-aged women, including sexually active teens, due to its high degree of effectiveness and ease of use. Recent research suggests, however, that condom use may be lower among teens who use LARC compared with moderately effective methods (i.e., pill, patch, ring, injectables).
Methods: We analyzed 2007-2011 Pregnancy Risk Assessment Monitoring System (PRAMS) data for the prevalence of postpartum condom use with LARC or other moderately effective methods among teens ≤ 19 years who recently delivered a live birth. Analyses were restricted to 15 states that had weighted response rates of 65% or higher. Multivariable logistic regression was conducted using adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) to assess concomitant use of condoms with LARC versus other moderately effective methods.
Results: Among 4,995 teen mothers who used LARC or moderately effective methods postpartum, 40% reported also using condoms. Condom use was lower overall among teen mothers who used LARC [23%, 95%CI=18-28] versus those who used moderately effective methods [44%, 95%CI=41-47]. This pattern persisted across age and race/ethnicity categories. After adjustment for age and race, multivariable modeling revealed that condom use was lower among teen mothers using LARC versus moderately effective methods postpartum [aOR=0.38, 95%CI=0.29-0.51] and higher among teens aged ≤17 versus 18-19 [aOR=1.27, 95%CI=1.02-1.59].
Conclusions: Only 40% of teen mothers reported using condoms postpartum, and use of condoms was markedly lower for teens relying on LARC versus other moderately effective methods. Given teens are at higher risk of sexually transmitted diseases, promotion of dual protection strategies are important for this population and may be more salient for those using LARC methods.