Factors associated with never‐use of long‐acting reversible contraception among adult reproductive‐aged women in Ohio

Abstract

Background The number of women using long‐acting reversible contraception (LARC)—intrauterine devices (IUDs) and implants—is increasing and 14% of contraceptive users in the United States adopt LARC. We examined correlates of LARC never‐use in a population‐based survey of reproductive‐aged women in Ohio. Methods We analyzed data from the 2018‐19 Ohio Survey of Women. We examined the prevalence of LARC never‐use and reasons for never‐use among ever users of contraception (N = 2388). Using Poisson regression to generate prevalence ratios (PRs), we examined associations between selected correlates (demographic factors, healthcare access/quality measures, and religious/political views) and LARC never‐use. Results Most Ohio women (74%) had never used LARC. Commonly reported reasons for not using an IUD or an implant were preferring a different method (46% and 45%, respectively), not wanting an object inside their body (45% and 43%), side effect concerns (39% and 33%), insertion/removal concerns (31% and 25%), and unfamiliarity (13% and 20%). Conservative political views (PR: 1.12, 95% confidence interval [CI]: 1.04–1.22), pro‐life affiliation (PR: 1.11, 95% CI: 1.02–1.20), placing high importance on religion in daily life (PR: 1.15, 95% CI: 1.06–1.26), and being non‐Hispanic white as compared to non‐Hispanic Black (PR: 1.20, 95% CI: 1.02–1.41) were significantly associated with LARC never‐use. Findings were generally similar for models analyzing IUD and implant never‐use separately. Conclusions Among ever‐users of contraception, LARC never‐use was associated with having conservative political views, being religious, and having a pro‐life affiliation. Except for race/ethnicity, demographic and healthcare measures were not associated with LARC never‐use among women in Ohio.