Barriers and Facilitators to Adolescents' Use of Long-Acting Reversible Contraceptives

J Pediatr Adolesc Gynecol. 2017 Feb;30(1):18-22. doi: 10.1016/j.jpag.2016.07.002. Epub 2016 Jul 28.


Most pregnancies among teenagers are unintended and many can be attributed to contraception misuse or nonuse. The etonogestrel implant and intrauterine devices, referred to as long-acting reversible contraceptives, or LARCs, are the most effective reversible contraceptive methods. These methods are safe for use by adolescents, yet the number of LARC users remains low among adolescents in the United States. In this review we examine recent literature about barriers and facilitators to LARC use among adolescent women. Factors that influence decision-making and provision are organized into 4 categories: (1) cost and clinical operations; (2) adolescent awareness and attitudes; (3) confidentiality, consent, and parental attitudes; and (4) health care provider knowledge, attitudes, and counseling. Knowledge deficits and misconceptions among adolescents and their health care providers are key barriers to adolescent LARC use.

Keywords: Adolescents; Barriers; Contraception; Long-acting reversible contraception; Qualitative; Teen pregnancy.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adolescent Behavior
  • Choice Behavior
  • Confidentiality
  • Contraception / psychology
  • Contraception / statistics & numerical data*
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Contraceptive Agents, Female / therapeutic use*
  • Desogestrel / therapeutic use*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / statistics & numerical data
  • Humans
  • Intrauterine Devices / statistics & numerical data*
  • Professional-Patient Relations
  • United States


  • Contraceptive Agents, Female
  • etonogestrel
  • Desogestrel