Depo-Provera (DMPA), an injectable contraceptive method approved by the FDA almost a decade ago, has one of the lowest failure rates among reversible and permanent methods of contraception. Because the method offers 3 to 4 months of effective contraceptive protection, there is little opportunity for method failure if women return for timely reinjection. Given the higher failure rates of other methods, Depo-Provera could play a significant role in preventing unintended pregnancies if women continue to use the method over time.
In 1997, California expanded state-funded clinical family planning services to increase access to services among low-income women and men. Family PACT, the new state program, is unique in its size (over 1.1 million women and men served per year) and its high level of DMPA use. Almost 300,000 DMPA injections are provided each year and nearly 20% of female clients served receive DMPA services. Teenagers, Latinas and women with many children are more likely to receive DMPA services than other women in Family PACT.
Over 60% of women receiving DMPA return to the Family PACT Program within four months to have a second injection. Adolescents and adults appear to have similar reinjection rates though there are significant ethnic and parity differences. Only 56% of African Americans return for a second injection and 37% for a third, compared to 64% and 44% of whites, and 61% and 43% of Latinas (p<0.00). The extent of DMPA provision in Family PACT allows for comparison of use among a diverse population of women.
Learning Objectives: 1. Describe the trends in use of Depo-Provera among the large, diverse population of Family PACT clients. 2. Define “reinjection” and “continuation rates.” Understand the difficulty in measuring these using claims data. 3. Compare Depo-Provera use in Family PACT to state and national levels.
Keywords: Contraception, Access and Services
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.