Teen girls who use IUDs to prevent pregnancy often skip condoms

More and more teenage girls are using intrauterine devices and other long-acting reversible contraceptives, or LARCs. That’s one reason the teen pregnancy rate has plunged. But those girls are using condoms less often than girls who take oral contraceptives, according to a new analysis published in JAMA Pediatrics.

Why it matters:

LARCs are more than 99 percent effective at preventing pregnancy, and their use has doubled between 2010 and 2015. But IUDs and hormonal implants  — which work by preventing sperm from fertilizing an egg — don’t protect women from sexually transmitted diseases or infections.

You’ll want to know:

The study looked at information provided by 2,288 high school girls who were sexually active. About 2 percent used LARCs, 22 percent used oral contraceptives, and 41 percent used condoms, with the rest choosing other birth control methods or no contraception at all. The study found that high school girls using LARCs were 60 percent less likely to also be using a condom during sex than the girls who were taking oral contraceptives. They were also more likely to have reported two or more recent sexual partners, which increases their risk for STDs and STIs.

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But keep in mind:

Risk for pregnancy and sexually transmitted infections vary from patient to patient, said Dr. Mary Landry, an obstetrician-gynecologist with the University of Wisconsin who was not involved in the study. “We don’t routinely tell all LARC users they need to use condoms, too,” Landry said. “I have an individual conversation with each patient about what her risks are.” For instance, girls engaging in same-sex intercourse don’t need protection against pregnancy.

The bottom line:

Public health experts say that while LARCs are more effective than oral contraceptives at protecting against pregnancy, health care providers need to make sure adolescents are aware of how to protect themselves from STDs and STIs, too.

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