Long-Acting Reversible Contraception Use and Unmet Desire among Patients After the Zika Contraception Access Network Program in Puerto Rico.

OBJECTIVE: To describe unmet desire for long-acting reversible contraception (LARC) after the Zika Contraception Access Network (Z-CAN) in Puerto Rico during the 2016-2017 Zika outbreak.

STUDY DESIGN: Z-CAN patients completed web-based surveys about contraception experiences over a three-year period.

RESULTS: Of 1,809 survey respondents, 3% never used LARC, but reported wanting it since their initial visit. As reasons for not getting LARC, nearly 50% indicated a provider-related reason and 25% reported cost.

CONCLUSIONS: Few Z-CAN patients who never used LARC had unmet LARC desire. Provider training in contraception guidelines and strategies to address costs can expand access to the full range of reversible contraception.

IMPLICATIONS: Three years after a short-term program provided reversible contraception in Puerto Rico, few respondents had never used but wanted a long-acting reversible contraception (LARC) method. Nearly half reported provider-related reasons for not receiving LARC, and 25% reported cost. Provider awareness of contraceptive guidance and method availability can support client-centered care.