Long-acting reversible contraception use and unmet desire among patients after the Zika Contraception Access Network Program in Puerto Rico

Contraception. 2024 Mar 27:110441. doi: 10.1016/j.contraception.2024.110441. Online ahead of print.

Abstract

Objectives: To describe unmet desire for long-acting reversible contraception (LARC) after the Zika Contraception Access Network (Z-CAN) in Puerto Rico during the 2016-2017 Zika outbreak.

Study design: Z-CAN patients completed surveys about contraception experiences over a 3-year period.

Results: Of 1809 respondents, 3% never used LARC but reported wanting it since their initial visit. As reasons for not getting LARC, nearly 50% indicated a provider-related reason and 25% reported cost.

Conclusions: Few Z-CAN patients who never used LARC had unmet desire. Provider training in contraception guidelines and strategies to address costs can expand access to the full range of reversible contraception.

Implications: Three years after a short-term program provided reversible contraception in Puerto Rico, few respondents had never used but wanted a long-acting reversible contraception method. Nearly half reported provider-related reasons for not receiving long-acting reversible contraception, and 25% reported cost. Provider awareness of contraceptive guidance and method availability can support client-centered care.

Keywords: Client-centered contraception counseling; Contraceptive implant; Emergency response; Intrauterine device; Long-acting reversible contraception; Zika.