Uptake, discontinuation, and continuation rate of long-acting contraceptive methods (LARC) when offered at no cost in Campinas, Brazil.

To compare the uptake, reasons for discontinuation, continuation, and satisfaction of long-acting contraceptive methods (LARC) when offered at no cost in Campinas, Brazil. A prospective cohort study conducted at University of Campinas, Campinas, SP, Brazil, including women aged 18-43 years, who adopted one of three methods. Participants underwent telephone follow-up every three months for up to 24 months after insertion. Satisfaction was assessed at the end of two years of use through the Likert scale. We invited 1,222 women and among the 971 women who volunteered to participate in follow-up; 414 (42.6%) chose the levonorgestrel 52-mg intrauterine device (IUD), 358 (36.9%) the etonogestrel (ENG)-implant and 199 (20.5%) the TCu380A IUD. Discontinuation due to bothersome bleeding was higher among users of the ENG-implant (10/358; 2.4%) and the TCu380A IUD (32/199; 8.9%), and expulsion was higher for the TCu380A IUD (30/199; 15.1%). Women continued at 24 months were 340/414; 82.1%, 270/358; 75.4%, and 119/199; 59.8% among users of the levonorgestrel 52-mg IUD, ENG-implant, and TCu380A IUD, respectively. The users of the levonorgestrel 52-mg IUD (301/339; 88.8%), the ENG-implant (222/270; 82.2%), and the TCu380A IUD (105/119; 88.2%) were satisfied or very satisfied by 24 months of follow-up. The three LARC methods had great uptake, high continuation and discontinuation due to bothersome bleeding was higher among users of the ENG-implant and the TCu380A IUD, and expulsion was higher for the TCu380A IUD compared to the 52-mg levonorgestrel IUD. Most of the participants reported being very satisfied. When the LARC methods were offered at no cost in a Brazilian public clinic the uptake, satisfaction and continuation were high by 24-months after device placement and high level of satisfaction was reported by most of the participants.

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