Study Finds Condom Use Lower Among Some, But Not All, Women Who Start Using a LARC Method

WASHINGTON, DC (October 3, 2022)—As use of long-acting reversible contraception (LARC) has increased, public health professionals have worried that LARC users might be less likely to use condoms and miss out on their ability to reduce transmission of sexually transmitted infections (STIs). In a study selected as the Editor's Choice for the September/October issue of Women's Health Issues, authors examined condom use by new LARC users and found it to be lower among those aged 20-34. 
 
Women's Health Issues is the official journal of the Jacobs Institute of Women’s Health, which is based in the Department of Health Policy and Management at Milken Institute School of Public Health (Milken Institute SPH) at the George Washington University.
 
Using data from the National Survey of Family Growth, Mieke CW Eeckhaut and Katie Fitzpatrick of the University of Delaware identified participants who began using a LARC method (contraceptive implant or intrauterine device) or a moderately effective method (pill, injectable, patch, or ring) between 2008 and 2018 and examined their condom use in the year following contraceptive method initiation. They compared condom use between the two groups overall and within different age ranges (13–19; 20–24; 25–29; 30–34; 35–44), and they controlled for sociodemographic characteristics and the number of male sex partners in the past 12 months. 
 
The authors found lower condom use among those who initiated LARC use compared to those who had started using moderately effective methods, but the differences disappeared for the youngest and oldest participants after controlling for sociodemographic factors and the number of male partners. A difference remained for those aged 20-34. “Efforts to improve male condom use among women initiating other contraceptive methods should be considered, including provider counseling about condom use for STI prevention with all contraceptive users at risk of STIs, especially in light of the current historic highs in STI cases,” Eeckhaut and Fitzpatrick recommend.
 
“This research provides additional evidence that current options for preventing STI transmission while avoiding pregnancy are inadequate,” said Amita Vyas, Editor-in-Chief of Women's Health Issues and associate professor of prevention and community health at Milken Institute SPH. “Women and others at risk of unwanted pregnancy deserve better options for exercising reproductive autonomy while protecting their health.”
 
“Are LARC Users less Likely to Use Condoms? An Analysis of U.S. Women Initiating LARC in 2008–2018” has been published in the September/October 2022 issue of Women's Health Issues.