Using most effective forms of contraception like intrauterine devices and implants may inadvertently increase the risk of sexually transmitted infections by discouraging condom use in high school girls, new findings suggest.
The latest study revealed that girls who use long-acting reversible contraception are significantly less likely to use condoms than girls on birth control pills. The study also revealed that girls on long-acting reversible contraception have more sexual partners than those on other forms of birth control.
Researchers said the findings are important because teens and young adults in their 20s account for nearly half of all new sexually transmitted infections.
"Long-acting reversible contraception, specifically intrauterine devices and implants, offers an unprecedented opportunity to reduce unintended pregnancies among adolescents because it is highly effective even with typical use," researchers wrote in the study.
"However, adolescent long-acting reversible contraception users may be less likely to use condoms for preventing sexually transmitted infections compared with users of moderately effective contraceptive methods (i.e., oral, Depo-Provera injection, patch, and ring contraceptives)," they added.
The latest study involved data from 2,288 sexually active girls participating in the 2013 U.S. Youth Risk Behavior Survey, which involved a nationally representative sample of high school students in grades nine through 12.
Study analysis revealed that 1.8 percent of the girls in the study used long-acting reversible contraception, 5.7 percent used the Depo-Provera shot, 22.4 percent used birth control pills, 40.8 percent used condoms and 11.8 percent used withdrawal or other method. The study also revealed 11.8 percent of the girls in the study used withdrawal or other method, 15.7 percent used no contraception and 1.9 percent weren't sure.
In light of the latest findings, study author suggest that doctors limit the availability of intrauterine devices and other forms of long-acting reversible contraception.
"There is a clear need for a concerted effort to improve condom use among adolescent long-acting reversible contraception users to prevent sexually transmitted infections, particularly as adolescent long-acting reversible contraception use increases," wrote study authors. "Our finding that long-acting reversible contraception users are less likely to use condoms in comparison with oral contraceptive users suggests that it may be beneficial for clinicians to specifically promote condoms for sexually transmitted infection prevention."
However, other experts disagree with researchers' suggestion of limiting the most effective form of birth control. Experts writing in an accompanying editorial say that doctors should promote the use of both long-acting reversible contraception and condoms.
"We need to work on crafting a clear message about pregnancy prevention and sexually transmitted infection prevention. Withholding long-acting reversible contraception - the most effective methods of reversible contraception - owing to concerns about the unintended consequence of decreased condom use is not the answer," wrote Dr. Julia Potter of the Boston Medical Center and Dr. Karen Soren of the Columbia University Medical Center in an accompanying editorial.
"Condoms still need to be part of the conversation because sexually transmitted infections are common in the adolescent population," added Potter and Soren. "Dual protection for sexually active adolescents should be encouraged so that adolescents are not exposed to the risk of pregnancy or the risk of sexually transmitted infections as a result of selecting condom use vs. effective contraception use. Condoms and long-acting reversible contraception complement each other. We need to get the message right."
The latest findings are published in the journal JAMA Pediatrics.
