Factors associated with never-use of long-acting reversible contraception among adult reproductive-aged women in Ohio

• Authors: Payal Chakraborty, The Ohio State University; Shibani Chettri, The Ohio State University; Maria F Gallo, The Ohio State University; Mikaela H Smith, The Ohio State University; Robert B Hood, Emory University; Danielle Bessett, University of Cincinnati; John Casterline, The Ohio State University; Alison H Norris, The Ohio State University; Abigail Norris Turner, The Ohio State University
• Journal Title: PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH
• Volume: Volume 55, Number 1
• Publisher: Guttmacher Institute | 2023-03-01, Pages 38-48
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1363/psrh.12212
• Subjects: Health Sciences, Epidemiology
• Keywords: contraception; long-acting reversible contraception; intrauterine devices; implant; Ohio; reproductive health; United States

Abstract

Background: The number of women using long-acting reversible contraception (LARC) – intrauterine devices (IUDs) and implants – is increasing and 14% of contraceptive users in the United States adopt LARC. We examined correlates of LARC never-use in a population-based survey of reproductive-aged women in Ohio. Methods: We analyzed data from the 2018-19 Ohio Survey of Women. We examined the prevalence of LARC never-use and reasons for never-use among ever users of contraception (N=2,388). Using Poisson regression to generate prevalence ratios (PRs), we examined associations between selected correlates (demographic factors, healthcare access/quality measures, and religious/political views) and LARC never-use. Results: Most Ohio women (74%) had never used LARC. Commonly reported reasons for not using an IUD or an implant were preferring a different method (46% and 45%, respectively), not wanting an object inside their body (45% and 43%), side effect concerns (39% and 33%), insertion/removal concerns (31% and 25%), and unfamiliarity (13% and 20%). Conservative political views (PR: 1.12, 95% confidence interval [CI]: 1.04-1.22), pro-life affiliation (PR: 1.11, 95% CI: 1.02-1.20), placing high importance on religion in daily life (PR: 1.15, 95% CI: 1.06-1.26), and being non-Hispanic white as compared to non-Hispanic Black (PR: 1.20, 95% CI: 1.02-1.41) were significantly associated with LARC never-use. Findings were generally similar for models analyzing IUD and implant never-use separately. Conclusions: Among ever-users of contraception, LARC never-use was associated with having conservative political views, being religious, and having a pro-life affiliation. Except for race/ethnicity, demographic and healthcare measures were not associated with LARC never-use among women in Ohio.