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

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