UCSF

INTRODUCTION: The authors' objective was to assess knowledge of and perceived access to long-acting reversible contraceptives (LARC) among individuals in the United States considering tubal sterilization. METHODS: Using online convenience sampling through social media advertisements, the authors recruited 442 US-born individuals considering tubal sterilization for this cross-sectional study. Eligibility criteria included age 21-45 years, female sex, premenopausal, desire to avoid future pregnancy, and no history of tubal sterilization, hysterectomy, or infertility treatment. After confirming eligibility, participants completed a 45-item online survey assessing sociodemographic characteristics, contraceptive and pregnancy history, and awareness of LARC. Chi-square tests and multivariate linear regression were used to identify sociodemographic variables associated with knowledge of and perceived access to LARC. RESULTS: Among these diverse (39% Black, 36% White, 10% Hispanic and Latinx) participants, 89% had heard of the implant and 92% had heard of the intrauterine device (IUD). Less than half reported having discussed LARC with a clinician in the past year; 47% had discussed IUDs and 31% the implant. Participants correctly answered an average of 37% of implant knowledge questions and 39% of IUD knowledge questions. Misconceptions that IUD (73%) or implant (83%) use may cause weight gain were particularly prevalent. In multivariate analyses, participants residing in the south had less knowledge of the implant than those in the midwest (β = -.50; 95% CI, -0.92 to -0.09). DISCUSSION: US individuals considering tubal sterilization may lack information about LARC relevant to informed contraceptive decision-making. CONCLUSION: Person-centered contraceptive counseling and shared decision-making should ensure that patients considering tubal sterilization are well informed about and can access alternative contraceptives, including LARC.