Keeping an Eye on STI in the Age of LARC

Date: November 5th, 2012

Valerie Sedivy

In case you have been under a rock for the past few years, LARCs (otherwise known as Long Acting Reversible Contraceptives) are all the rage in the teen pregnancy prevention community. While implants and injectable contraception have been promoted for many years in this age group, the resurgence of the IUD (intrauterine device) has refocused our attention on LARCs in a big way. Given what we know about the failure rate of other contraceptive methods among teens, this may well be a good thing.

On the other hand, maybe it’s not as simple as it seems. By promoting LARCs among teens, are we inadvertently discouraging condom use? A recent Journal of Adolescent Health study suggests that this may be the case. Now keep in mind that this study only pointed to an association between the use of LARCs and decreased condom use. We cannot say for sure that the use of LARCs caused the decline in condom use. But it does suggest cause for concern. We all want to help teens avoid pregnancy in the most effective way possible, and clearly LARCs help us achieve that aim—and I would wager that none of us wants to do so at the expense of rising rates of STIs. As we all know, some STIs have consequences far more severe than pregnancy.

So what do we do? Do you have a clear and compelling way to make the case that condoms are still essential, even when a teen has the pregnancy risk covered? Is it realistic that teens will do both? After all, many may choose to use LARCs once they are in an ‘established’ relationship when they perceive the risks of STIs to be low to none. At what point is it OK to say “go ahead and skip the condom”? Is it ever OK?

Do the field a favor and share your thoughts and ideas. We need to address this issue more than ever. While teen pregnancy rates are on the decline, rates of STIs among this age group are still far too high and may climb higher if the use of LARCs increases at the expense of condom use.

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About the Author

Valerie Sedivy, Ph.D., Healthy Teen Network Senior Program Manager, has over 25 years of experience in the sexual health field and currently supports professionals to provide programs and services that empower youth to thrive. Her experience in multiple roles including program provider, researcher, evaluator, capacity-building assistance provider, resource developer and project manager has instilled a passion for translating research into practical messages and tools for field staff.

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