Abstract
OBJECTIVE: To examine current levels, correlates of, and changes in contraceptive use among reproductive-age women in the United States between 2014 and 2016. DESIGN: We conducted simple and multivariable logistic regression analyses to identify associations between user characteristics and contraceptive use, with specific attention to methods requiring a visit to a health care provider. SETTING: Not applicable. PATIENTS: All self-identified female respondents to the surveys. Secondary analysis of two rounds of the National Survey of Family Growth, an in-home, nationally representative survey of people ages 15-44 years (2013-2015) and 15-49 years (2015-2017). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Current use of a contraceptive method, including use of individual methods and grouped method use in 2016, and change in use from 2014. RESULTS: Contraceptive use remained steady between 2014 and 2016 among sexually active females not seeking pregnancy (88%). Among users, use of long-acting reversible contraceptive (LARC) methods increased from 14% to 18%, as use of short-acting reversible contraceptive (SARC) methods fell from 32% to 28%. Implant use among 15- to 19-year-olds rose from 6% to 16% and represents one of the largest increases observed. Access to sexual and reproductive health care was strongly associated with use of all LARC and SARC methods except for the implant (adjusted odds ratios ranged from 3.21 to 13.53). CONCLUSIONS: Contraceptive users are shifting primarily among the most and moderately effective method groups, and not from contraceptive nonuse to use. Reductions in access to sexual and reproductive health care could have implications for individuals' ability to use their preferred contraceptive methods.