Adolescent and Young Adult Women's Knowledge of and Attitudes Toward Etonogestrel Implants

Study Objective: Long acting reversible contraceptives, including etonogestrel implants, are top tier contraceptives for adolescents, yet they remained underutilized. This study aimed to assess awareness of and attitudes toward etonogestrel implants among adolescent and young adult women. Design, Main Outcome Measures: This is a cross sectional study. We distributed an original, self-administered survey to a convenience sample of anonymous subjects. The survey assessed demographic information, pregnancy and sexual history, general contraceptive preferences, and awareness of implants. Subjects then read a brief description of implants before completing the section assessing attitudes toward them. We used chi-square and t-test analyses to identify factors associated with awareness of and positive attitudes toward implants. Setting, Participants: Women aged 10-24 attending a birth control education group at an adolescent health center in New York City. Results: Of the 129 participants, only 40% had heard of etonogestrel implants. Some (33%) reported positive attitudes toward implants. Positive attitudes were associated with preferences for birth control convenience (OR=3.3, 95% CI=1.1- 9.5) and privacy (OR=2.2, 95% CI=1.0- 4.8). Neutral or negative attitudes were associated with a preference for birth control that maintained menstrual regularity (OR=0.4, 95% CI=0.2- 0.8) and with having experienced at least 1 unintended pregnancy (OR=0.4, 95% CI=0.2- 0.9). Age, race, and education were not associated with participants' attitudes toward implants. Conclusions: Women who value convenience and privacy are more likely to report positive attitudes toward implants, and thus may represent especially receptive candidates for them.