Fear of intrauterine contraception among adolescents in New York City

Objective The intrauterine contraceptive device (IUD) is one of the most effective contraceptive methods, but it remains underutilized, especially among adolescents. Little is known about how adolescents perceive IUDs. The objective of this study is to explore urban, minority female adolescents' attitudes and beliefs about IUDs and to identify barriers to IUD use. Study design Qualitative semistructured interviews were conducted with 21 adolescents aged 14 to 21 years who had heard about the IUD but never used one personally. Participants were recruited from two urban school-based health clinics and one community health center. Individual interviews were audiotaped and transcribed. Themes were identified by two independent researchers through line-by-line analysis of interview transcripts. Results Fear of the IUD predominated. Respondents related fears about pain, expulsion, foreign body and the potential for physical harm. Common themes in support of the IUD included the IUD's superior efficacy compared to other contraceptive methods and the ability to use this method long term. Despite identifying IUD benefits, most respondents did not appear to think the method would be well suited for them. Conclusion Though the IUD is safe and effective for adolescents, we found that urban female adolescents have many device-related concerns which must be addressed to make this method more acceptable. Implications Understanding urban, minority adolescents' perspective on IUDs and their specific concerns about IUD method use can help clinicians provide targeted and relevant contraceptive counseling.