While about 90 percent of sexually active teens used birth control the last time they had sex, public health officials said Tuesday that only 5 percent nationally are using the most effective type.
The data does show that Iowa teens, however, are well above national averages in their use of that type — and with one of the highest percentages in the country — generally referred to as long-acting reversible contraception (LARC).
Increasing access to LARC — including intrauterine devices (IUDs) and implants — can help reduce teen pregnancy, Centers for Disease Control and Prevention officials said Tuesday during a conference call with reporters.
Less than 1 percent of LARC users become pregnant during the first year of use. That's compared with a 9 percent chance for those who take oral contraceptives and an 18 percent chance for those who use condoms.
“We need to remove barriers and increase awareness, access and availability of long-acting reversible contraception such as IUDs and implants,” CDC Principal Deputy Director Ileana Arias said.
The use of LARC — which prevents pregnancy for three to 10 years — among teenagers has increased at Title X centers since 2005, rising from less than 1 percent to 7 percent in 2013.
CDC data shows that the use of implants — a matchstick-sized device containing hormones inserted in the upper arm — accounted for most of the increase in LARC use.
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CDC officials said this is likely due to teenagers seeing implants as less invasive than IUDs, small T-shaped devices inserted into the uterus.
Health groups such as the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics have endorsed LARC as a first-line contraceptive choice, health officials said.
But there are still improvements to be made, the CDC said.
Barriers include lack of education, high upfront costs — unsubsidized, the devices can cost $800 to $1,000 — and misconceptions among teens that they are too young to use the devices. This has contributed to a broad range of use among states, officials said.
Colorado had the highest percentage of teen clients using LARC (25.8 percent). It's followed by Alaska (19.6 percent), Washington, D.C.(17.9 percent) and Iowa (16.6 percent).
The lowest percentage of teen clients using LARC was in West Virginia (2 percent), Indiana (1.5 percent) and Mississippi (0.7 percent).
High use in Iowa
Significant funding from an anonymous donor helped jump-start Iowa's LARC use through the Iowa Initiative to Reduce Unintended Pregnancy.
The program, which ran from 2007 to 2012, gave Title X centers — federally funded family planning centers — the resources to develop infrastructure, purchase supplies, train providers and staff, expand hours and locations, and provide marketing, said Polly Carver-Kimm, a spokeswoman for the Iowa Department of Public Health (IDPH).
Title X agencies always have focused on client-centered counseling, Carver-Kimm said, adding clients are given information about abstinence as well as all forms of birth control.
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Title X centers offer confidential services to teenagers and do not require parental consent. There was no state funding involved in the project, and the IDPH did not receive any funding from the donor.
“Without that funding, a lot of our patients would not have been able to access those devices,” said Valerie Campbell, clinic manager of the UnityPoint Health-St. Luke's Family Health Center in Cedar Rapids.
Campbell added that during that time, Iowa Medicaid Enterprise's Iowa Family Network waiver began paying for LARC. The program covers annual exams, sexually transmitted disease testing and treatment, and birth control for females aged 12 to 54 years old, according to the Iowa Department of Human Services.
These two programs greatly increased access to teenagers, college students, and low-income women, she said.
“We would not be where we are today without (the Iowa Initiative)” she said.