Continuation of reversible contraception in teenagers and young women

OBJECTIVE: To examine the effect of age on continuation rates of reversible contraceptive methods among females aged 14-19 years and women aged 20-25 years compared with women older than 25 years of age. METHODS: We analyzed data from 7,472 participants enrolled in the Contraceptive CHOICE Project, a prospective cohort study of women offered no-cost contraception. Our primary objective was to compare 12-month continuation rates between females aged 14-19, 20-25, and 26 years and older. We collected data about method continuation from telephone surveys and chart review. We used Kaplan-Meier survival curves to estimate continuation and Cox proportional hazard models to examine the risk of contraceptive method discontinuation. RESULTS: Twelve-month continuation of long-acting reversible contraceptive (LARC) methods was more than 75% for all age groups. Females aged 14-19 years using LARC methods had slightly lower continuation rates (81%) than older women (85-86%), but this did not reach statistical or clinical significance. Compared with women older than 25 years of age, females aged 14-19 years had higher discontinuation rates for non-LARC methods (53% compared with 44%; adjusted hazard ratio 1.32, 95% confidence interval [CI] 1.02-1.73). The females aged 14-19 years were less likely to be satisfied with non-LARC methods (42% compared with 51%; adjusted relative risk 0.80, 95% CI 0.65-0.98), but not with LARC methods (75% compared with 83%; relative risk 0.94, 95% CI 0.88-1.01) when compared with women older than 25 years of age; however, the differences were small. CONCLUSION: Teenagers and young women have high rates of LARC method continuation.