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As Zika Looms, Are LARCs the Answer?

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FROM MMWR

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In U.S. states where mosquito-borne Zika virus transmission is possible, adult women at risk for unintended pregnancy and sexually active high school girls are primarily using moderately effective and less effective contraceptive methods, according to a report from the Centers for Disease Control & Prevention.

Long-acting reversible contraceptives (LARCs) – considered a highly effective method – are used by fewer than a quarter of nonpregnant women, about one-third of recently postpartum women, and fewer than one-tenth of sexually active high school girls, according to a report published Aug. 2 in the Morbidity and Mortality Weekly Report (doi: 10.15585/mmwr.mm6530e2).

Hormonal IUD Robert Boston/Washington University

Hormonal IUD

With locally transmitted cases of Zika virus infection increasing rapidly in Florida, the CDC is urging that the full range of FDA-approved contraceptive methods should be readily available and accessible to women who want to avoid or delay pregnancy.

“Given low rates of LARC use, states can implement strategies to remove barriers to the access and availability of LARC including high device costs, limited provider reimbursement, lack of training for providers serving women and adolescents on insertion and removal of LARC, provider lack of knowledge and misperceptions about LARC, limited availability of youth-friendly services that address adolescent confidentiality concerns, inadequate client-centered counseling, and low consumer awareness of the range of contraceptive methods available,” the CDC scientists wrote in the MMWR report.

Among nonpregnant women and recently postpartum women, the proportion not using any contraception ranged from 3.5% to 34.3%. Among sexually active high school girls, the proportion using no contraception ranged from 7.3% to 22.8%. The estimates of contraceptive use are based on 2011-2013 and 2015 survey data from four state-based surveillance systems.

The full MMWR report is available here.

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