Michal Fishel Bartal

Objective The authors aimed to identify factors associated with long‐acting reversible contraception (LARC) usage. Methods The current cross‐sectional study used data from the National Survey of Family Growth from 2011 to 2019. Respondents aged 15 to 44 years were included. Those with previous sterilization, infertility, or pregnant were excluded. The outcome evaluated was use of a LARC. Results Of 61 543 814 women, 44 287 911 (72.0%) met inclusion criteria. The rate of LARC use was 13.4%. Factors associated with an increased likelihood of LARC usage were married/living with a partner (adjusted relative risk [aRR], 1.18 [95% CI, 1.02–1.37]), perceived good health (aRR, 1.44 [95% CI, 1.13–1.84]), year of survey 2017 to 2019 (aRR, 1.53, [95% CI, 1.28–1.83]), one or two past pregnancies (aRR, 1.62 [95% CI, 1.24–2.12]) or three or more past pregnancies (aRR, 1.67 [95% CI, 1.22–2.28]), age at first live birth <20 years (aRR, 1.58 [95% CI, 1.20–2.08]) or 20 to 24 years (aRR, 1.45 [95% CI, 1.13–1.87]), age at onset of sexual activity 13–19 years (aRR, 1.50 [95% CI, 1.26–1.78]), and a 0‐ to 5‐month period of nonintercourse in the past year (aRR, 1.63 [95% CI, 1.40–1.90]). Factors associated with decreased LARC usage were age ≥ 35 years (aRR, 0.74 [95% CI, 0.65–0.85]), being non‐Hispanic Black (aRR, 0.75 [95% CI, 0.62–0.89]) or non‐Hispanic other (aRR, 0.72 [95% CI, 0.59–0.88]), intending to have children (aRR, 0.65 [95% CI, 0.57–0.74]), and never being sexually active (aRR, 0.10 [95% CI, 0.06–0.16]). Conclusions Using a nationally representative sample of women in the United States, the authors identified modifiable factors associated with LARC use. Results may be used to plan interventional trials to increase LARC usage.