P-214: Contraceptive use and access to long-acting reversible contraception in adolescents with diabetes
C Reis Gerhardt, E Oliveira Santayana De Lima, M Frosi Amaral, L Loss Reck Remonti, M Puñales, F Satler, C Bauermann LeitaoAbstract
Introduction
Adolescents with diabetes mellitus (DM) are at increased risk of adverse pregnancy outcomes, making effective contraception essential. However, data on contraceptive use and access to long-acting reversible contraception (LARC) in this population remain limited.
Objectives
To evaluate contraceptive use and access to LARC among adolescents with DM and identify associated clinical and sociodemographic factors.
Methods
Cross-sectional study including adolescent females with DM followed at a tertiary care center. Data were collected from medical records and structured interviews, including sociodemographic variables, sexual and reproductive history, contraceptive use, access to LARC, and clinical parameters (HbA1c, presence of complications). Descriptive and comparative analyses were performed.
Results
A total of 374 adolescents with diabetes mellitus were included, with a mean age of 13.8 years; 91.4% had type 1 DM. The overall mean HbA1c was 9.1%. Sexual activity was reported by 16.6% of participants (n=62). Among these, 61.3% reported current contraceptive use, whereas 38.7% were not using any method despite being sexually active. The use of long-acting reversible contraception (LARC) was 2.1%. Among users of non-LARC methods, 19.3% reported forgetting contraception, suggesting potential inconsistency in use. Regarding access and counseling, only 32.6% of participants reported availability of LARC in primary care settings, while 39.6% were unaware of its availability. Furthermore, only 8.8% reported having been offered LARC by a healthcare provider.
Conclusions
Despite the clear need for effective contraception in adolescents with DM, LARC use remains extremely low. Limited counseling and low reported availability suggest significant gaps in access to highly effective contraceptive methods. These results highlight gaps in health services that represent opportunities to improve reproductive health outcomes in this high-risk population.