Who uses long-acting reversible contraception? Profile of LARC users in the CUPID cohort

To explore the characteristics of long-acting reversible contraception (LARC) users in a nationally representative cohort of young Australian women aged 18-23.

Data from 3155 women who responded to a question about their contraceptive use in the previous six months at the baseline Contraceptive Use, Pregnancy Intention and Decisions (CUPID) survey were included.

726 (19.1%) women reported LARC use, with the Implanon being the most popular method (n = 478; 65.8%). A history of pregnancy was strongly associated with increased odds of LARC use in the multivariate model (OR = 2.67, 95% CI = 2.11, 3.34, p ≤ 0.001). Comparatively, using contraception for reasons other than pregnancy prevention was associated with decreased odds of LARC use in the multivariate model (period management: OR = 0.74, 95% CI = 0.60, 0.91, p = 0.004, body management: OR = 0.53, 95% CI = 0.37, 0.77, p = 0.001, medical condition: OR = 0.25, 95% CI = 0.09, 0.66, p = 0.005). Highest education and Medicare card status also contributed to the final multivariate model, and were associated with decreased odds of LARC use.

Reproductive history and reasons for contraceptive use are strong indications of method choice. Promoting LARC as highly effective may not be a sufficient incentive for young women to take up the method when pregnancy prevention may be equal or secondary to their desired non-contraceptive effects.