Teenagers & Long-Acting Reversible Contraception

The AAP's Committee on Adolescence has published its recommendations in a report -- "Long-Acting Reversible Contraception: Specific Issues for Adolescents" -- in the July 2020 issue of the journal Pediatrics. For those whose hair curls at the mention of adolescent sexuality, this report is going to set their hair on fire. It is, however, a balanced a well-reasoned report that covers the bases. A few highlights:

• The long-acting reversible contraceptives (LARC) are one progestin subdermal implant (Norplant, I presume) and five IUDs. The report states that they "are all appropriate for use in the adolescent population."
• "[R]ates of LARC use among sexually active adolescents remain low at 2% to 3%" (emphasis added).
• Safety concerns, noncontraceptive uses of LARC, side effects, timing issues, and adolescents with physical and/or cognitive disabilities are discussed in detail.

I am not in a position to comment on the clinical analyses above. But the report goes on to discuss issues that are well within the scope of HealthLawBlog:

• Consent, confidentiality, and cost concerns -- which are complex and intertwined with one another -- are discussed but remain far from resolved. It's not hard to see why these issues are a major obstacle to the use of LARC by minors, especially for purposes of contraception. For this discussion alone, the report is well worth reading.

For a quick overview, check out Contemporary Pediatrics (7/21/20).