TY - JOUR
T1 - Long-Acting Reversible Contraceptives for Incarcerated Women
T2 - Feasibility and Safety of On-Site Provision
AU - Sufrin, Carolyn
AU - Oxnard, Tianyi
AU - Goldenson, Joe
AU - Simonson, Kristin
AU - Jackson, Andrea
N1 - Publisher Copyright:
© 2015 by the Guttmacher Institute.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - CONTEXT: Many incarcerated women have an unmet need for contraception. Providing access to long-acting reversible contraceptive (LARC) methods-IUDs and implants-before release is one strategy to meet this need and potentially prepare them for reentry to the community, but the safety and feasibility of providing these methods in this setting have not been described. METHODS: A retrospective descriptive study of all LARC insertions at the San Francisco County Jail in 2009-2014 was conducted. Data from community clinic and jail clinic databases were assessed to examine baseline characteristics of LARC initiators, complications from insertion, method continuation, and pregnancy and reincarceration rates. Correlates of method discontinuation were assessed in multivariate logistic regression analyses. RESULTS: Eighty-seven LARC devices were inserted during the study period-53 IUDs and 34 implants. There were no cases of pelvic inflammatory disease or other insertion complications in IUD users and no serious complications in implant users. Median duration of known use was 11.4 months for IUDs and 12.9 months for implants. Women who discontinued a LARC method most commonly cited a desire to get pregnant (32%). Black women were more likely than whites to discontinue use (odds ratio, 4.4). CONCLUSIONS: It is safe and feasible to provide LARC methods to incarcerated women. Correctional facilities should consider increasing access to all available contraceptives, including LARC methods, in a noncoercive manner as a strategy to reduce reproductive health disparities among marginalized women at high risk of unplanned pregnancies.
AB - CONTEXT: Many incarcerated women have an unmet need for contraception. Providing access to long-acting reversible contraceptive (LARC) methods-IUDs and implants-before release is one strategy to meet this need and potentially prepare them for reentry to the community, but the safety and feasibility of providing these methods in this setting have not been described. METHODS: A retrospective descriptive study of all LARC insertions at the San Francisco County Jail in 2009-2014 was conducted. Data from community clinic and jail clinic databases were assessed to examine baseline characteristics of LARC initiators, complications from insertion, method continuation, and pregnancy and reincarceration rates. Correlates of method discontinuation were assessed in multivariate logistic regression analyses. RESULTS: Eighty-seven LARC devices were inserted during the study period-53 IUDs and 34 implants. There were no cases of pelvic inflammatory disease or other insertion complications in IUD users and no serious complications in implant users. Median duration of known use was 11.4 months for IUDs and 12.9 months for implants. Women who discontinued a LARC method most commonly cited a desire to get pregnant (32%). Black women were more likely than whites to discontinue use (odds ratio, 4.4). CONCLUSIONS: It is safe and feasible to provide LARC methods to incarcerated women. Correctional facilities should consider increasing access to all available contraceptives, including LARC methods, in a noncoercive manner as a strategy to reduce reproductive health disparities among marginalized women at high risk of unplanned pregnancies.
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U2 - 10.1363/47e5915
DO - 10.1363/47e5915
M3 - Article
C2 - 26484795
AN - SCOPUS:84949963009
VL - 47
SP - 203
EP - 211
JO - Perspectives on Sexual and Reproductive Health
JF - Perspectives on Sexual and Reproductive Health
SN - 1538-6341
IS - 4
ER -