My Take: Dual Use Approaches to Preventing Teen Pregnancy and STIs

By Amy Peterson, MSc | January 9, 2014

Late last year, several ETR colleagues and I presented at the Healthy Teen Network’s annual conference in Savannah, Georgia. The theme was “Embracing Innovation: Combining Science with Creativity to Improve Adolescent Health.” About 30 participants joined ETR staffer Bruce Weiss and me as we discussed strategies for addressing unintended pregnancy and STIs among young people through the dual use of long-acting reversible contraception (LARCs) and condoms.

That Pregnancy Probably Is Not Planned

Most teens who get pregnant aren’t planning to. In fact, over 80% of teen pregnancies are unintended. Many of these are due to failed contraceptive use—the condom breaks, a girl forgets to take a pill, teens let time lapse between a completed pregnancy and resuming the use of contraception. However, if couples use a contraceptive method with a low failure rate, such as an IUD or implant, the likelihood of pregnancy decreases dramatically. These types of contraception are known as long-acting reversible contraception or LARCs.

LARCs could be one of the most promising current solutions for reducing the rate of unintended pregnancies. While there are some myths and misconceptions, many years of research tell us that LARCs are not only safe for adolescents, but that many young women prefer them over other methods. Now that the Affordable Care Act covers contraceptive costs, more women in the United States will have access to LARCs than ever before.

What About STI Prevention?

This is exciting news for the field of adolescent pregnancy prevention! But, because LARCs don’t protect against sexually transmitted infections (STIs), public health professionals have some concerns. If young people start using LARCs to prevent pregnancy, will they stop using condoms altogether? What will this mean for STI rates among teens? After all, although young people make up only 27% of the sexually active population, they account for over 50% of STIs—infections that can lead to more serious problems, including infertility and cancer.

Dual Method Use: A Workable Solution

This is where dual method use comes in. The use of LARCs and condoms together helps prevent STIs, including HIV, and provides added protection against unintended pregnancy. Our colleagues at the HTN conference brainstormed some strategies educators and public health professionals can use to encourage dual method use in young people. Here are a few of their ideas:

• Make referrals to known teen-friendly health centers that will prescribe LARCs and provide condoms to adolescents. Check out this teen-friendly center guide from FHI 360.
• When educating teens about contraception, start with the most effective methods and simultaneously talk about condoms.
• Model condom communication and negotiation skills and provide young people with opportunities to practice these skills in a safe space.
• Advocate for condom availability programs and STI testing at or near schools. Check out ETR’s free PATHS Guide for linking schools to HIV testing.
• Train educators and health care professionals on the latest LARC research and ways to address challenges to condom use. See the Journal of Adolescent Health’s free LARC Supplement.

What creative strategies is your organization or school using to address unintended pregnancy and STIs? We’d love to hear your ideas and hope you’ll join the conversation.

Amy Peterson, MSc, is a project coordinator and professional development specialist at ETR, where she coordinates an agency-wide initiative to implement research-based professional learning practices. Contact her at amy.peterson@etr.org.