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Successful Provision of Long-Acting Reversible Contraception in a Sexual Health Clinic

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Same-day insertion of intrauterine devices for patients receiving family planning services in the Denver Sexual Health Clinic was not associated with an increased risk of pelvic inflammatory disease. Background Women… Click to show full abstract

Same-day insertion of intrauterine devices for patients receiving family planning services in the Denver Sexual Health Clinic was not associated with an increased risk of pelvic inflammatory disease. Background Women who attend sexual health clinics are at high risk for sexually transmitted infections and unintended pregnancy. Long-acting reversible contraceptives (LARC) are very effective contraceptive methods, but the provision of LARC in such clinics is not well described in the literature. Methods We conducted a retrospective chart review of women who presented to Denver Sexual Health Clinic for any reason and received family planning services between April 1, 2016, and October 31, 2018. We assessed demographic and clinical factors associated with contraceptive method received and conducted a subanalysis of those with intrauterine device (IUD) insertions on the same-day versus delayed insertion. Among those who received an IUD, we assessed rates of pelvic inflammatory disease (PID) 30 days after insertion. Results Of the 5064 women who received family planning services in our clinic, 1167 (23%) were using a LARC method at the time of their visit. Of the 3897 who were not using a LARC, fewer women, 12.6%, chose LARC (IUD and progestin implant), compared with 33.3% who chose new short-acting reversible contraceptives. Further analysis of the 270 IUD initiators revealed 202 (74.8%) received the IUD on the same day, whereas 68 (25.2%) had delayed IUD insertion. There were 9 incident cases of gonorrhea or chlamydia in those who received same-day IUD and 1 incident case among those who had delayed IUD insertion. There were no cases of PID at 30 days after insertion in either group. Conclusions Study findings support IUD provision in a sexual health clinic on the day of initial visit without increased risk of PID.

Keywords: health; day; acting reversible; insertion; sexual health; health clinic

Journal Title: Sexually Transmitted Diseases
Year Published: 2022

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