‘We’re kidding ourselves if we say that contraception is accessible’: a qualitative study of general practitioners’ attitudes towards adolescents’ use of long-acting reversible contraceptives (LARC)

ABSTRACT INTRODUCTION Adolescents’ uptake of long-acting reversible contraceptives (LARCs) in New Zealand is low. We created the concept of a proactive LARC provision programme to overcome barriers to LARC uptake. Previously, this concept was discussed with adolescents and positively received. Lack of provider awareness is a barrier to LARC use identified in previous research and by adolescents. AIM We sought the views of general practitioners (GPs) to gauge whether LARCs and their proactive promotion for use in adolescents may be acceptable to GPs. METHODS Nine New Zealand GPs were interviewed about their contraception provision to adolescents and were then asked to comment on the concept of a proactive LARC provision programme. The data collected were transcribed and analysed using a general inductive approach to identify common themes and ideas. We concurrently interviewed and analysed interviews and continued to recruit GPs until thematic saturation was reached. RESULTS Six themes were identified from the interviews: (1) contraceptive decision making; (2) the GP role; (3) sexual activity; (4) social context; (5) gauging adolescent understanding; and (6) youth. When we proposed the concept of a proactive LARC provision programme, the GPs responded positively. DISCUSSION The research demonstrates that LARC uptake is affected by limited provider awareness. These findings align with other research internationally that identifies barriers to adolescent contraceptive use. The findings of this study suggest that other GPs may support a proactive LARC provision programme in New Zealand.