Although the teenage pregnancy rate has decreased over the past decade, the US still has the highest teen birth rate among developed countries . The most effective method of contraception for adolescent girls is long-acting reversible (LARC) such as intrauterine devices (IUDs) and subdermal implants . Unfortunately most teenagers continue to use less reliable methods such as condoms [3,4]. In 2011-2013, 59.1% of sexually active teenagers in the US used condoms for contraception, while 19% used birth control pills, 4.7% used either a shot/patch/vaginal ring, and only 1.6% used LARC . These numbers still remained low in 2006-20103. In addition, the 2006-2010 National Survey of Family Growth (NSFG) data shows that LARC use has significantly increased only in women 18 years and older. This is concerning as LARC use is most effective in preventing teen pregnancies if used at the onset of sexual activity especially since many teenagers in the US have their first sexual experience by 16 years of age .
The contraceptive CHOICE project has shown that once the barriers of cost and lack of awareness/knowledge was removed, a little over half of the teenagers enrolled in the study chose to receive LARC . Nevertheless, it is important to realize that despite the removal of these barriers, a little less than half of sexually active women did not wish to receive LARC. Although there have been multiple studies investigating teens and decision-making regarding hormonal contraceptive-use, emergency-contraceptive use, and LARC use after having a pregnancy [8-10], we were able to find only one study on young women and LARC decision-making . In this study, Sundstrom et al. found that among barriers to LARC uptake were discouragement by medical provider, costs, misconceptions, and perceived risks. These participants, however, were sampled from a university, which introduced a substantial amount of sampling bias. Nevertheless, the study does introduce some potential factors that teenagers consider when choosing contraception, namely costs, potential pain or discomfort, irregularities in menstrual cycle or emotional status, and perceived risks to health. To investigate this topic further, we surveyed teenagers and young women who attended an inner-city hospital-based clinic in Houston. Knowledge regarding LARC and factors that were important in choosing a contraceptive method were ascertained by the survey.