The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2026
Perceptions of Long-Acting Reversible Contraception and Reproductive Health Counseling Among Adolescents and Young Adults With Chronic Medical Conditions: A Qualitative Study.
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Borzutzky Claudia, Sayegh Caitlin, Rocha Jessica, Johnson Emily M, Jin Emmy, Hinesley Nichole, Nielsen Diana, Iverson Ellen
Аннотация
PURPOSE: To explore attitudes towards and perceived barriers to long-acting reversible contraceptives (LARCs) as contraception options among adolescents and young adults (AYAs) with chronic medical conditions (CMCs), and their reproductive health counseling experiences with pediatric subspecialty providers.
METHODS: We conducted a qualitative study of 67 AYA females aged 16 to 21 years, currently living with a CMC. We completed 17 focus groups and 16 individual interviews. Using thematic analysis procedures and qualitative analytical software, we reviewed narrative data, created codes, and identified key themes.
RESULTS: The mean age of participants was 19.81 years; 40% had been sexually active, all of whom had used a contraceptive method other than withdrawal. Five prominent patient-centered themes were identified: (1) positive and negative perceptions of LARC, (2) fertility concerns and goals, (3) balancing contraception options with other medications, (4) LARC in the context of medical trauma, and (5) views heavily informed by family and friends. Three themes related to patients' views of providers were also identified: (1) provider readiness for providing contraception counseling, (2) provider biases related to sexual and reproductive health, (3) providers deferring responsibility to other providers. One inter-patient-provider theme (missed opportunities for shared decision-making) was generated from qualitative narrative data. Despite frequent contact with pediatric subspecialty providers, participants' description of encounters suggested missed opportunities for shared decision-making around contraception and pregnancy planning.
DISCUSSION: This qualitative study reveals diverse attitudes and beliefs about LARC among AYA with CMC, and suggests that valuable opportunities exist for improved reproductive and sexual health counseling and care by their pediatric subspecialty teams.
METHODS: We conducted a qualitative study of 67 AYA females aged 16 to 21 years, currently living with a CMC. We completed 17 focus groups and 16 individual interviews. Using thematic analysis procedures and qualitative analytical software, we reviewed narrative data, created codes, and identified key themes.
RESULTS: The mean age of participants was 19.81 years; 40% had been sexually active, all of whom had used a contraceptive method other than withdrawal. Five prominent patient-centered themes were identified: (1) positive and negative perceptions of LARC, (2) fertility concerns and goals, (3) balancing contraception options with other medications, (4) LARC in the context of medical trauma, and (5) views heavily informed by family and friends. Three themes related to patients' views of providers were also identified: (1) provider readiness for providing contraception counseling, (2) provider biases related to sexual and reproductive health, (3) providers deferring responsibility to other providers. One inter-patient-provider theme (missed opportunities for shared decision-making) was generated from qualitative narrative data. Despite frequent contact with pediatric subspecialty providers, participants' description of encounters suggested missed opportunities for shared decision-making around contraception and pregnancy planning.
DISCUSSION: This qualitative study reveals diverse attitudes and beliefs about LARC among AYA with CMC, and suggests that valuable opportunities exist for improved reproductive and sexual health counseling and care by their pediatric subspecialty teams.