BACKGROUND: Women who attend sexual health clinics are at high risk for sexually transmitted infections and unintended pregnancy. Long-acting reversible contraceptives (LARC) are very effective contraceptive methods, but the provision of LARC in such clinics is not well described in the literature. METHODS: We conducted a retrospective chart review of women who presented to Denver Sexual Health Clinic for any reason and received family planning services between April 1, 2016, and October 31, 2018. We assessed demographic and clinical factors associated with contraceptive method received and conducted a subanalysis of those with intrauterine device (IUD) insertions on the same-day versus delayed insertion. Among those who received an IUD, we assessed rates of pelvic inflammatory disease (PID) 30 days after insertion. RESULTS: Of the 5064 women who received family planning services in our clinic, 1167 (23%) were using a LARC method at the time of their visit. Of the 3897 who were not using a LARC, fewer women, 12.6%, chose LARC (IUD and progestin implant), compared with 33.3% who chose new short-acting reversible contraceptives. Further analysis of the 270 IUD initiators revealed 202 (74.8%) received the IUD on the same day, whereas 68 (25.2%) had delayed IUD insertion. There were 9 incident cases of gonorrhea or chlamydia in those who received same-day IUD and 1 incident case among those who had delayed IUD insertion. There were no cases of PID at 30 days after insertion in either group. CONCLUSIONS: Study findings support IUD provision in a sexual health clinic on the day of initial visit without increased risk of PID.

From 2014–2019, reported cases of three nationally notifiable sexually transmitted infections (STI) − chlamydia, gonorrhea, and primary and secondary (P&S) syphilis − have been rising in the United States (US).(https://www.cdc.gov/std/statistics/2019/default.htmhttps://www.cdc.gov/std/statistics/2019/default.htm) During this time, health inequities persisted by age with a higher burden among adolescents and young adults, and by race-ethnicity with a higher burden among subgroups other than non-Hispanic whites and non-Hispanic Asians. Racial-ethnic inequities in STI are also prevalent among adolescents aged 15–19 years. Factors commonly associated with STI that may have contributed to the recent STI increases include sexual behavior and networks, STI testing, and contextual factors (e.g., social determinants).