长效可逆避孕(LARC)方法,包括左炔诺孕酮和铜宫内节育器(IUD)和皮下避孕植入物,是最有效的可逆避孕方式,因此是预防青少年怀孕的一个重要方面。虽然LARC功效,安全,适当性得到了主要医疗机构的支持,使用率不断提高,美国(US)青少年对LARC的总体摄取仍然低于对短效避孕方法的摄取.更好地了解影响青少年LARC吸收的障碍和停药的原因可能有助于促进有效的沟通。例如,学习如何改善以青少年为中心的沟通,共同决策,动机咨询策略可能是提高利用率的第一步。这篇叙述性综述包括三个部分。首先,这篇评论将描述历史,行动机制,以及美国和全球青少年LARC使用的流行病学。接下来,这篇综述将描述影响青少年LARC摄取的关键因素,停药的原因,以及青少年LARC使用特有的多层次障碍。最后,本综述将以健康信念模型框架中的生殖正义方法为背景,描述青少年的沟通技术和LARC咨询策略.从假定的咨询方法转向以青少年为中心的区别,鼓励父母与青少年性健康沟通的共同决策方法,为增强青少年生殖自主权奠定基础,应该是所有有效生殖沟通策略的基础。
Long-acting reversible contraception (LARC) methods, including levonorgestrel and copper intrauterine devices (IUDs) and the subdermal contraceptive implant, are the most effective reversible forms of contraception and thus are an important aspect of adolescent pregnancy prevention. While LARC efficacy, safety, and appropriateness are supported by major medical organizations and usage rates are increasing, overall LARC uptake among United States (US) adolescents remains lower than uptake of short-acting contraceptive methods. A better understanding of the barriers affecting adolescent LARC uptake and reasons for discontinuation could help facilitate effective communication. For example, learning how to improve adolescent-centered communication, shared decision-making, and motivational counseling strategies may be the first step to improving utilization rates. This narrative
review includes three sections. First, this
review will describe the history, mechanisms of action, and epidemiology of adolescent LARC use in the US and globally. Next, this
review will describe key factors influencing adolescent LARC uptake, reasons for discontinuation, and multilevel barriers specific to adolescent LARC use. Finally, this
review will characterize communication techniques and LARC counseling strategies for adolescents in the context of a reproductive justice approach set in the health belief model framework. The distinction between moving away from a presumptive counseling approach towards an adolescent-centered, shared decision-making approach to encourage parent-adolescent sexual health communication to lay the foundation of empowering adolescent reproductive autonomy should be the underpinning of all effective reproductive communication strategies.