ATLANTA — Knowledge of intrauterine devices among adolescent and young adult women is limited, according to a study presented at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
In a cross-sectional survey of 144 young women between the ages of 14 and 24 recruited from an adolescent gynecology clinic, gynecology outpatient clinics, and the community, more than half of the participants had never heard of an intrauterine device (IUD) and 97% had never used one, said Dr. Lisa Johnson of the adolescent medicine division of the Nassau (Bahamas) Department of Public Health.
The 20-minute, 44-item, semistructured interview assessed demographics, sexual history, contraceptive use and attitudes, and IUD knowledge and attitudes, Dr. Johnson said. The mean age of the respondents was 18.8 years. Nearly all (97%) of them were single, 58% were African American, and 39% were white. Approximately 84% of the group had ever been sexually active, with a mean age of 15.8 years at first sexual intercourse and a median of three lifetime partners. Among those who had ever had sex, 76% had ever been pregnant and 67% had ever had a sexually transmitted disease.
According to the survey results, 60% of the young women surveyed had never heard of an IUD, yet a majority of them “agreed” or “strongly agreed” that they would consider a birth control method that resulted in less painful (93%) and lighter (91%) periods and gave them control over when to stop (85%) and start it (80%), Dr. Johnson said. In addition, 61% reported being “willing” or “very willing” to use a birth control method that causes irregular vaginal bleeding if it was 99% effective at preventing pregnancy, she said.
However, only 30% of the respondents said they would consider a birth control method that involved placing a small plastic object in the uterus and only 27% said they would be interested in a device that had to be placed and removed by a health care provider, she noted.
An analysis of the survey responses showed that those who had heard of IUDs were significantly more likely to be older and sexually active compared with those who had not heard of them, and they were more likely to be white, Dr. Johnson said. “There was no association between knowledge of IUDs and ever being pregnant, parity, ever having a sexually transmitted disease, or number of sexual partners,” she said.
Following participation in the survey, each of the young women was given a 2-minute description and demonstration of IUDs, followed by a test of knowledge about the birth control method. “After the IUD demonstration, knowledge scores were significantly increased,” said Dr. Johnson. “Nearly 65% of the young women liked the idea of an IUD for themselves, while 12% were neutral and 24% said they disliked the idea,” she reported.
Those who liked the IUDs for themselves were significantly more likely to be sexually active than those who did not or who were neutral, Dr. Johnson reported. “There was no association between liking IUDs and age, race, ever being pregnant, parity, ever having a sexually transmitted disease or number of sexual partners,” she said.
Among the young women who liked the idea of an IUD, the most appealing characteristics were that it did not require them to remember to use it every day, that it would not affect their ability to have children in the future, and that it did not need to be remembered with each sex act, Dr. Johnson said.
The findings suggest that “young women may not be getting sufficient information on all of the contraceptive options available to them, particularly IUDs,” said Dr. Johnson. “Clinicians should discuss IUDs as an option with these patients and demonstrate how they are used in order for [patients] to make an informed decision about contraception.”