ACCESS TO LONG-ACTING REVERSIBLE CONTRACEPTION AND ITS EFFECT ON UPTAKE AMONG LATINA ADOLESCENTS: TRENDS OVER 6-MONTHS

Purpose: Long-acting reversible contraception(LARCs) are the most effective contraception options for all women including adolescents. Access to LARCs has been identified as a barrier. However, there is a paucity of research examining how LARC access may influence adolescents' contraceptive choices, especially among Latinas. This study examines the association between LARC availability on-site at schoolbased health centers (SBHCs) and uptake of LARCs among sexually active Latinas aged 14-18 years. Methods: This study is part of a larger, randomized control trial of the impact of Health-E You/Salud iTu, an app to support contraception decision making, at 18 SBHCs in Los Angeles, California. We examined 334 sexually active Latinas from the 9 intervention SBHCs who at baseline were not using a LARC, not pregnant, wanted to avoid pregnancy, were given the app and completed at least one of three follow-up surveys (48 hours, 3-months, and 6-months) that measured attitudes and contraception use. Separate multivariate logistic regression models assessed associations between on-site access and LARC use at each survey timepoint, adjusted for participant's interest in LARC (surveyed after app use, before the clinic visit), contraceptive self-efficacy, sexual activity, feelings regarding pregnancy, and language preference. Results: At the time of the clinic visit, 45% of participants had on-site access to a LARC method and 27% expressed interest in using a LARC method. Across the three follow-up surveys, LARC utilization ranged from 6% to 8% of participants. Participant interest in a LARC method was significantly associated with uptake of a LARC at the clinic visit as noted at 48 hours (OR=7.39, 95%CI 2.31-23.65, p=0.001), any use of a LARC in the prior 3-month period at 3 months (OR=4.71, 95%CI 1.5214.53, p=0.007), and current use of a LARC at 6-months (OR=5.59, 95%CI 1.84-16.93, p=0.003) respectively. Compared to participants whose SBHC did not have on-site LARC access, those with on-site access were significantly more likely to use a LARC at 6-month follow-up (OR=2.92, 95%CI 1.11-7.71, p=0.031). This approached significance at the 3-month follow-up (OR=3.57, 95%CI 0.95-13.35, p=0.059); however, it was not significantly associated with uptake the day of the clinic visit (OR=2.22, 95%CI 0.58-8.55, p=0.244). Conclusions: Participants with interest in LARCs had increased uptake of LARC devices for contraception at each time period when compared to participants who did