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May 20, 2019

Long-Acting Reversible Contraceptive Methods Need a Barrier to Prevent Sexually Transmitted Infections in Adolescents

Author Affiliations
  • 1Adolescent Center, Kaiser Permanente Washington, Seattle
  • 2Kaiser Permanente Washington Health Research Institute, Seattle
JAMA Pediatr. 2019;173(7):624-626. doi:10.1001/jamapediatrics.2019.1133

Intrauterine devices and contraceptive implants are safe, highly effective first-line contraceptive options for adolescents. As use of these long-acting reversible contraceptive (LARC) methods has steadily risen among teenagers and young adults, pregnancy rates among these groups have declined.1 Specifically for postpartum adolescents, choosing to initiate a LARC method shortly after pregnancy has been found to decrease the substantial risk of a short interpregnancy interval, thus creating opportunities for healthier families and communities.2 At the same time, sexually transmitted infection (STI) rates in the United States are rising, and adolescents and young adults, including those who are pregnant, continue to experience a disproportional burden of STIs.3 Thus, there has been speculation as to whether increasing LARC use among adolescents is playing a role in rising STI rates, and prior cross-sectional data among adolescents have shown that having a LARC method is associated with lower condom use.4 “Dual use” of highly effective contraception and condoms remains an important health behavior among all sexually active adolescents to reduce the 2 risks of unplanned pregnancy and STIs.