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Contraception
May 2019

Contraceptive use by women across different sexual orientation groups

Brittany M. Charlton,Harvard T.H. Chan School of Public Health
Elizabeth Janiak,Brigham and Women's Hospital, Harvard Medical School
Audrey J. Gaskins,Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health
Amy D. DiVasta,Boston Children's Hospital, Harvard Medical School
Rachel K. Jones,Guttmacher Institute
Stacey A. Missmer,Michigan State University
Jorge E. Chavarro,Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health
Vishnudas Sarda,Boston Children's Hospital
Margaret Rosario,Boston Children's Hospital
S. Bryn Austin,Boston Children's Hospital, Harvard Medical School, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health
Reproductive rights are under attack. Will you help us fight back with facts?
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First published online: May 10, 2019 DOI: https://doi.org/10.1016/j.contraception.2019.05.002

Objectives
To examine contraceptive methods used across sexual orientation groups.

Study Design
We collected data from 118,462 female participants in two longitudinal cohorts—the Nurses’ Health Study (NHS) 2 (founded in 1989, participants born 1947-1964) and NHS3 (founded in 2010, born 1965-1995). We used log-binomial models to estimate contraceptive methods ever used across sexual orientation groups and cohorts, adjusting for age and race.

Results
Lesbians were the least likely of all sexual orientation groups to use any contraceptive method. Lesbians in NHS2 were 90% less likely than heterosexuals to use long-acting reversible contraceptives (LARCs; adjusted risk ratio [aRR]; 95% confidence interval [CI]: 0.10 [0.04, 0.26]) and results were similar for other contraceptive methods and in the NHS3 cohort. Compared to the reference group of completely heterosexual participants with no same-sex partners, those who identified as completely heterosexual with same-sex partners, mostly heterosexual, or bisexual were generally more likely to use any method of contraception. Use of LARCs was especially striking across sexual minority groups, and, with the exception of lesbians, they were more likely to use LARCs; as one illustration, NHS3 bisexuals were more than twice as likely to use LARCs (aRR [95% CI]: 2.01 [1.67, 2.42]).

Conclusions
While certain sexual minority subgroups (e.g., bisexuals) were more likely than heterosexuals to use contraceptive methods such as LARCs, lesbians were less likely to use any method.

Implications
Many sexual minority patients need contraceptive counseling and providers should ensure to offer this counseling to patients in need, regardless of sexual orientation.

Full article available online in Contraception
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Topic

United States

  • Contraception
  • HIV & STIs
  • Pregnancy

Geography

  • United States

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LGBTQ

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