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Access Barriers to Long-Acting Reversible Contraceptives for Adolescents.
Natasha Kumar1, Joanna D Brown2
1Warren Alpert Medical School of Brown University, Providence Rhode Island.
Summary
Long-acting reversible contraceptives are recommended for adolescents, but access barriers persist. Addressing costs, confidentiality, provider training, and patient awareness is crucial for effective implementation.
Area of Science:
- Public Health
- Adolescent Medicine
- Reproductive Health
Background:
- The U.S. has the highest adolescent birth rate among industrialized nations.
- New guidelines recommend long-acting reversible contraceptives (LARCs) as first-line contraception for adolescents.
- Professional consensus supports LARCs for adolescent use.
Purpose of the Study:
- To summarize existing barriers to LARC access for adolescents in the U.S.
- To identify areas for intervention to facilitate LARC integration into clinical practice.
- To inform effective implementation of professional recommendations.
Main Methods:
- Narrative review of U.S. studies published after 2000.
- Analysis of identified access barriers to LARCs for adolescents.
Main Results:
- Key barriers include institutional and recipient costs, consent and confidentiality issues, provider attitudes/misconceptions/training gaps, and patient awareness/misconceptions.
- Systemic policy interventions are needed for cost and confidentiality.
- Individual-level barriers require interventions from medical organizations and training programs.
Conclusions:
- Systemic policy changes (e.g., Affordable Care Act) are essential to address cost and confidentiality.
- Targeted interventions for providers and patients are necessary to overcome individual-level barriers.
- Effective implementation of LARC recommendations requires a multi-faceted approach addressing both systemic and individual factors.
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