Long-acting reversible contraception for adolescents and young adults – A cross-sectional study of women and general practitioners in Oslo, Norway

Abstract

Objectives To investigate awareness and use of long-acting reversible contraceptives (LARCs) in the Norwegian primary care sector.

Methods We surveyed 359 women aged 16 to 23 years visiting a free sexual health clinic and 140 general practitioners (GPs) in Oslo, Norway, to assess contraceptive usage patterns, knowledge, opinions, and counselling content.

Results Eighty-two percent (n = 295) of the female respondents were current contraceptive users and of this group, 12% (n = 34) were LARC users. Combined oral contraceptives (COCs, 56%) and condoms (20%) were the methods most commonly used. Apart from those two, the women considered themselves insufficiently knowledgeable about other family planning modalities. Knowledge was an independent predictor of current LARC use (p < 0.001). Approximately 35% of GPs often discussed LARC methods when counselling but, due to a lack of implant insertion training, only a few frequently discussed implants during counselling (odds ratio [OR]: 0.12; p = 0.013). The main determinant for not mentioning intrauterine devices and the intrauterine system during counselling was nulliparity (OR: 0.2; p = 0.001 and < 0.001, respectively).

Conclusion LARC use is low among 16 to 23-year-olds in Oslo, Norway. These young women need better contraceptive counselling. Dispelling misconceptions and improved provider training could encourage GPs to cover LARCs when giving contraceptive guidance.

Keywords:

• Counselling
• General practitioner
• Implant
• Intrauterine device
• Intrauterine system
• Long-acting reversible contraceptive

Declaration of interest: MB is the founder and CEO of RemovAid, a medical technology company focusing on contraceptive implant removal. ETA is an employee of RemovAid. MB and ETA hold shares in RemovAid. BIN is a Board member of Sex & Samfunn, a free sexual health clinic in Oslo. TA, ESS and JAL have no conflicts to disclose. The authors alone are responsible for the content and writing of the paper.