HIV-Related High Risk Sexual Behaviors and Practices Among Women in Bogotá, Colombia

ABSTRACT

Determinants associated with high-risk sexual behaviors were investigated in 1,133 sexually active women in Bogotá, Colombia. A self-administered questionnaire was completed by two groups of women: 721 representing the general population (GP), and 412 commercial sex workers (CSWs). High-risk sexual behaviors for HIV/AIDS were evident in both groups. Nevertheless, consistent condom use was reported by only 6% of the GP group, as compared to 67% of the CSWs. Failure to recognize high-risk routes for HIV infection was indicated in 69% of the GP women for anal sex, and by the majority of both groups for intercourse during menses (56% GP women and 54% CSWs). Multivariate analysis revealed that education level, actual age, and age of first sex experience were significant predictors of high-risk sexual practices. The necessity for educational programs regarding high-risk sexual practices and risk of HIV/ AIDS is evident for HIV/AIDS prevention.     

Assessment of Sexual Behavior,Sexual Attitudes,and Sexual Risk in Sweden (1989–2003)

To assess changes in sexual behavior, sexual attitudes, and sexual risk related to HIV, we conducted mailed questionnaire surveys in random samples of the Swedish general population in 1989, 1994, 1997, 2000, and 2003 (total N = 13,762). Each sample consisted of 4,000–6,000 subjects aged 16–44 years, stratified by age: 16–17, 18–19, 20–24, 25–34, and 35–44 years. The overall participation rate was 63.8% (for men, 55.9%; for women, 71.9%). The prevalence of three or more sexual partners and casual sexual contacts without the use of a condom was comparatively high for men, for persons aged 16–24 years, single persons with and without a regular partner, and persons living in towns and urban areas. The prevalence of multiple sexual partners and casual sexual contacts increased significantly over time. There was a significant decrease in the proportion of participants who agreed with the statement Sexual intercourse should only take place in a stable relationship. Personal risk assessments related to HIV did not change significantly over time. The study shows that risky sexual behavior related to HIV/AIDS increased in the Swedish population between 1989 and 2003, and that attitudes concerning casual sexual relations became more permissive.     

Trends in U.S. hospitalizations and inpatient deaths from pneumonia and influenza, 1996–2011

BackgroundTo reduce excess morbidity and mortality of pneumonia and influenza (PI), the Advisory Committee on Immunization Practices has recommended the use of 7-valent pneumococcal conjugate vaccine (PCV7), and incrementally expanded the target group for annual influenza vaccination of healthy persons, to ultimately include all persons ≥6 months of age without contraindications as of the 2010–2011 influenza season. We aimed to capture broader epidemiologic changes by looking at PI collectively.MethodsUsing interrupted time series, we evaluated the changes in the rates of PI hospitalization and inpatient death across three periods defined according to the changes in vaccination policy. We assessed linear trends adjusting for seasonality, sex, and age group, allowing for differential impact across age groups. PI hospitalizations were defined as a principal diagnosis of PI, or a principal diagnosis of sepsis or respiratory failure, accompanied by a secondary diagnosis of PI.ResultsOverall annual rates of PI hospitalizations and inpatient deaths declined by 95 per 100,000 (95% CI: 45–145) and by 4.4 per 100,000 (95% CI: 0.9–7.8), respectively. This translates to 295,000 fewer PI hospitalizations and 13,600 fewer PI inpatient deaths than expected based on the average rates from 1996 through 1999. PI hospitalizations dropped the most among seniors aged 65+ by 487 per 100,000, followed by children aged <2, by 228 per 100,000. PI inpatient deaths declined most among seniors aged 65+, by 25.3 per 100,000.ConclusionsIn this nationally representative study, PI hospitalizations and inpatient deaths decreased in U.S. between 1996 and 2011. There is a temporal association with the introduction and widespread use of pneumococcal conjugate vaccines, and the expansion of the target group for annual influenza vaccination to include all persons ≥6 months of age, while it is difficult to attribute these changes directly to specific vaccines used in this era.     

Trends in Injection Risk Behaviors among People Who Inject Drugs and the Impact of Harm Reduction Programs in Ukraine, 2007–2013

The study examined trends in injection risk behaviors among people who inject drugs (PWIDs) and assessed the impact of harm reduction programs in Ukraine during 2007–2013. We performed a secondary analysis of the data collected in serial cross-sectional bio-behavioral surveillance surveys administered with PWIDs in Ukraine in 2007, 2008, 2011, and 2013. Using data from 14 Ukrainian cities, we assessed short-term trends in injection risk behaviors with the Cochran-Armitage test for trend and multivariable logistic regression models, adjusted for age, sex, region, marital status, education level, occupation, age at injection drug use initiation, experience of overdose, and self-reported HIV status. The overall test for trend indicated a statistically significant decrease over time for sharing needle/syringe during the last injection (p?<?0.0001), sharing needle/syringe at least once in the last 30 days (p?<?0.0001), and using a common container for drug preparation (p?<?0.0001). The prevalence of injecting drugs from pre-loaded syringes was high (61.0%) and did not change over the study period. After adjusting for all significant confounders and comparing to 2007, the prevalence of sharing needle/syringe during the last injection was unchanged in 2008 (OR?=?1.06, 95% CI?=?0.92, 1.21), and declined in 2011 (OR?=?0.18, 95% CI?=?0.15, 0.22) and 2013 (OR?=?0.17, 95% CI?=?0.14, 0.21). Sharing needles/syringes in the last 30 days significantly decreased when compared to that in 2007 (2008: OR?=?0.81, 95% CI?=?0.74, 0.89; 2011: OR?=?0.43, 95% CI?=?0.38, 0.47; and 2013: OR?=?0.31, 95% CI?=?0.27, 0.35). The prevalence of using common instruments for drug preparation also decreased compared to that in 2007 (2008: OR?=?0.88, 95% CI?=?0.85, 0.91; 2011: OR?=?0.85, 95% CI?=?0.85, 0.90; and 2013: OR?=?0.74, 95% CI?=?0.71, 0.76). The observed reduction in the prevalence of injection risk behavior over time is encouraging. Our findings suggest that prevention programs in Ukraine have positive impact and provide support for governmental expansion of these programs.     

Trends in Childhood Influenza Vaccination Coverage—U.S., 2004–2012

Objective

We compared estimates of childhood influenza vaccination coverage by health status, age, and racial/ethnic group across eight consecutive influenza seasons (2004 through 2012) based on two survey systems to assess trends in childhood influenza vaccination coverage in the U.S.

Methods

We used National Health Interview Survey (NHIS) and National Immunization Survey-Flu (NIS-Flu) data to estimate receipt of at least one dose of influenza vaccination among children aged 6 months to 17 years based on parental report. We computed estimates using Kaplan-Meier survival analysis methods.

Results

Based on the NHIS, overall influenza vaccination coverage with at least one dose of influenza vaccine among children increased from 16.2% during the 2004–2005 influenza season to 47.1% during the 2011–2012 influenza season. Children with health conditions that put them at high risk for complications from influenza had higher influenza vaccination coverage than children without these health conditions for all the seasons studied. In seven of the eight seasons studied, there were no significant differences in influenza vaccination coverage between non-Hispanic black and non-Hispanic white children. Influenza vaccination coverage estimates for children were slightly higher based on NIS-Flu data compared with NHIS data for the 2010–2011 and 2011–2012 influenza seasons (4.1 and 4.4 percentage points higher, respectively); both NIS-Flu and NHIS estimates had similar patterns of decreasing vaccination coverage with increasing age.

Conclusions

Although influenza vaccination coverage among children continued to increase, by the 2011–2012 influenza season, only slightly less than half of U.S. children were vaccinated against influenza. Much improvement is needed to ensure all children aged ≥6 months are vaccinated annually against influenza.Recommendations to vaccinate children against influenza began in 1960, when people with certain health conditions that put them at increased risk of severe illness from influenza were recommended to receive annual influenza vaccination, implicitly including children with high-risk conditions.¹ The recommendations for influenza vaccination of children remained unchanged until 2002, when providers were encouraged to vaccinate all children aged 6–23 months, regardless of medical conditions,² and in 2004, when all children aged 6–23 months were explicitly recommended for vaccination.³ In 2006, the influenza recommendations were expanded to include annual vaccination for all children aged 6–59 months.⁴ Recommendations were further expanded in 2008 to include annual vaccination of all children aged 6 months to 18 years.⁵Since the 2010–2011 influenza season, annual influenza vaccination has been recommended for all people aged 6 months and older.⁶ Children aged 6 months to 8 years should receive two doses of influenza vaccine, spaced four weeks apart, during their first season of vaccination and then one dose per season in subsequent seasons.⁷ During inter-pandemic seasons through 2011–2012, trivalent influenza vaccine was available, providing protection against two influenza A subtypes and one type B strain. During the 2009–2010 influenza season, two influenza vaccines were recommended: the trivalent seasonal influenza vaccination and the pandemic influenza A(H1N1)pdm09 (pH1N1) monovalent vaccination.⁸The National Health Interview Survey (NHIS) and the National Immunization Survey-Flu (NIS-Flu) have been the primary surveys used to measure influenza vaccination coverage among children. NHIS, an in-person household survey, began collecting parental report of influenza vaccination in 2005.⁹ NHIS has been considered the most representative source for estimates of influenza vaccination coverage among children aged 6 months to 17 years and has served as the Healthy People data source for influenza vaccination estimates.¹⁰ NHIS, however, has not routinely allowed for state-level estimates and is not timely enough to enable the reporting of influenza estimates before the beginning of the next influenza season. NIS-Flu is an ongoing telephone survey of households with children aged 6 months to 17 years. National and state-level estimates of influenza vaccination coverage for children based on parental-reported vaccination status from NIS-Flu have been reported by fall of the subsequent influenza vaccination season.^11,12The aims of this study were to (1) examine estimates of childhood influenza vaccination coverage over time by age, race/ethnicity, and high-risk status; and (2) compare estimates from NHIS and NIS-Flu, the two main survey systems currently used to measure influenza vaccination coverage among children in the U.S.     

How many are underinsured? Trends among U.S. adults, 2003 and 2007

With health insurance moving toward greater patient cost sharing, this study finds a sharp increase in the number of underinsured people. Based on indicators of cost exposure relative to income, as of 2007 an estimated twenty-five million insured people ages 19-64 were underinsured-a 60 percent increase since 2003. The rate of increase was steepest among those with incomes above 200 percent of poverty, where underinsurance rates nearly tripled. In total, 42 percent of U.S. adults were underinsured or uninsured. The underinsured report high levels of access problems and financial stress. The findings underscore the need for policy attention to benefit design, to assure care and affordability.     

Test–Retest Reliability and Predictors of Unreliable Reporting for a Sexual Behavior Questionnaire for U.S. Men

Accurate knowledge about human sexual behaviors is important for increasing our understanding of human sexuality; however, there have been few studies assessing the reliability of sexual behavior questionnaires designed for community samples of adult men. A test–retest reliability study was conducted on a questionnaire completed by 334 men who had been recruited in Tucson, Arizona. Reliability coefficients and refusal rates were calculated for 39 non-sexual and sexual behavior questionnaire items. Predictors of unreliable reporting for lifetime number of female sexual partners were also assessed. Refusal rates were generally low, with slightly higher refusal rates for questions related to immigration, income, the frequency of sexual intercourse with women, lifetime number of female sexual partners, and the lifetime number of male anal sex partners. Kappa and intraclass correlation coefficients were substantial or almost perfect for all non-sexual and sexual behavior items. Reliability dropped somewhat, but was still substantial, for items that asked about household income and the men’s knowledge of their sexual partners’ health, including abnormal Pap tests and prior sexually transmitted diseases (STD). Age and lifetime number of female sexual partners were independent predictors of unreliable reporting while years of education was inversely associated with unreliable reporting. These findings among a community sample of adult men are consistent with other test–retest reliability studies with populations of women and adolescents.     

Changing SNAP-Participation Trends Among Farmworker Households in the U.S., 2003–2012

We investigated Supplemental Nutrition Assistance Program (SNAP) participation among citizen, documented and undocumented immigrant hired crop farmworkers for ten recent years. We analyzed population representative data from the National Agricultural Workers Survey for 2003–2012 (N?=?18,243 households). Time-chart, simple mean differences, and logistic regressions described farmworker household participation in SNAP. The 2008 financial crisis almost doubled SNAP-participation by agriculture households (6.5% in 2003–2007 vs. 11.3% in 2008–2012). The increasing SNAP-participation was found for citizen, documented and undocumented immigrant households. We found low participation among documented (OR 0.67, 95% CI 0.56–0.8) and undocumented immigrants (OR 0.63, 95% CI 0.54–0.74) compared to citizens. Low odds ratios (OR 0.70, 95% CI 0.55–0.89) were found for Hispanic-citizens as compared with non-Hispanic white-citizens. Our results may help inform the debate surrounding the effects of the financial crisis on SNAP-participation and on differences in participation among citizens, immigrants, Hispanics and non-Hispanics, the latter suggesting ethnic farmworker disparities in SNAP-participation.     

Patterns of Current Use of Tobacco Products Among U.S. High School Students for 2000–2012—Findings From the National Youth Tobacco Survey

PurposeThe purpose of this study was to assess patterns and trends of tobacco use among high school students to better understand which products are used individually or concurrently.MethodsData from the National Youth Tobacco Survey from 2000 through 2012 were used to assess patterns and trends of current tobacco use (cigarettes, cigars, smokeless tobacco, and other tobacco products) among U.S. high school students. We assessed use of products individually and concurrently.ResultsDuring 2000–2012, overall linear declines were observed in current use of any tobacco product from 33.6% to 20.4% (p < .05), current use of only 1 tobacco product, from 18.8% to 10.5% (p < .05), and current poly tobacco use, from 14.7% to 9.9% (p < .05), among high school students. Overall current use of only cigarettes had both a linear decline, from 14.0% to 4.7%, as well as a quadratic trend.ConclusionsDuring 2000–2012, the most significant overall decline observed was for students who reported smoking only cigarettes. The results suggest that more data on the use of multiple tobacco products, not just cigarettes, is needed to guide tobacco prevention and control policies and programs.     

Violent Behaviors in Early Adolescent Minority Youth: Results from a “Middle School Youth Risk Behavior Survey”

Objectives: To describe the prevalence and characteristics of violence and violence-related behaviors among six populations of U.S. minority adolescents in grades 6–8. Methods: Six thousand four hundred non-White adolescents were recruited from six sites that were part of a collaborative project. Surveys were administered either during the school day or at community facilities. All students at each site were asked 10 questions about recent violence-related behaviors (including use of threats, fighting, weapon carrying, and weapon use). Prevalence of each violence-related behavior was reported within and across sites, and stratified by race/ethnicity, gender, age, and other characteristics expected to influence the behaviors. Results: Sixty-six percent (66%) of the middle school students sampled reported being involved in some type of recent fighting and/or weapon-related behaviors. Sixty-one percent (61%) indicated some form of fighting behavior in the past 3 months (threatening to beat someone up, physical fighting, and/or being hurt in a fight). Thirty percent (30%) of participating youth reported one or more weapon-related behaviors (threatening to use a weapon, carrying a weapon, using a weapon, and/or being cut, stabbed or shot at). Reported gun carrying among males varied depending upon site, but was as high as 20%. Grade in school was positively associated with reported violent behaviors. Adolescents who reported living full-time with a parent or parent figure, and those who reported religious observance or beliefs, were less likely to report violence involvement. All violence-related behaviors were more common among male than female adolescents. Conclusions: Violence prevention efforts should begin in elementary school and continue throughout adolescence. Programs should be prepared to provide services or referrals to victims of violence, implement programs tailored toward females as well as males, and build partnerships with churches and other community organizations in which youth are involved.     

Where's the fat? Trends in U.S. diets 1965-1996

BACKGROUND: Controlling fat intake has been an ongoing health concern since the late 1950s. This study examines 30-year trends in food sources of fat intake. It focuses on both total fat and specific fatty acid classes to ascertain if there are trend differences by age, sex, or race/ethnicity. METHODS: Nationally representative cross-sectional U.S. Department of Agriculture surveys from 1965, 1977-1978, 1989-1991, and 1994-1996 form the basis of this analysis, which compares 45,357 adults aged 18 years and older. Food files linked over time are used to create comparable food groups and nutrient values. RESULTS: The proportion of fat in the diet from grain-based mixed dishes, higher-fat snack foods, and higher fat potatoes has increased to partially offset reductions in fat from dairy, red meat, and added fat categories. Food sources of fat differ by race/ethnicity and age. The percentage of fat from fast foods and ethnic foods increased over time from 1 to 11% of total fat. The ratio of visible to invisible fat declined considerably. CONCLUSION: While animal product-based sources of fat continue to require emphasis, the shift toward fast foods, fried foods, and grain-based mixed dish and edible oil sources requires more focus.     

Bridging Populations—Sexual Risk Behaviors and HIV Prevalence in Clients and Partners of Female Sex Workers,Bangkok, Thailand 2007

The aim of this study is to estimate HIV prevalence and assess sexual behaviors in a high-risk and difficult-to-reach population of clients of female sex workers (FSWs). A modified variation of respondent-driven sampling was conducted among FSWs in Bangkok, where FSWs recruited 3 FSW peers, 1 client, and 1 nonpaying partner. After informed consent was obtained, participants completed a questionnaire, were HIV-tested, and were asked to return for results. Analyses were weighted to control for the design of the survey. Among 540 FSWs, 188 (35%) recruited 1 client, and 88 (16%) recruited 1 nonpaying partner. Clients’ median age was 38 years. HIV prevalence was 20% and was associated with younger age at first sexual experience [relative risk (RR) = 3.10, 95% confidence interval (CI) 1.16–8.24] and condom use during last sexual encounter with regular partner (RR = 3.97, 95% CI 1.09–14.61). Median age of nonpaying partners was 34 years, and HIV prevalence was 15.1%. There were 56 discordant FSW–client pairs and 14 discordant FSW–nonpaying partner pairs. Condom use was relatively high among discordant FSW–client pairs (90.1%) compared to discordant FSW–nonpaying partner pairs (18.7%). Results suggest that sexual partners of FSWs have a high HIV prevalence and can be a bridge for HIV transmission to other populations. Findings also highlight the importance of initiating surveillance and targeted programs for FSW partners, and demonstrate a recruitment method for hard-to-reach populations.     

Sexual Risk Behaviors among African-American and Hispanic Women in Five Counties in the Southeastern United States: 2008–2009

PurposeWe examined sexual risk behaviors and unrecognized HIV infection among heterosexually active African-American and Hispanic women.MethodsWomen not previously diagnosed with HIV infection were recruited in rural counties in North Carolina (African American) and Alabama (African American), and an urban county in southern Florida (Hispanic) using multiple methods. They completed a computer-administered questionnaire and were tested for HIV infection.ResultsBetween October 2008 and September 2009, 1,527 women (1,013 African American and 514 Hispanic) enrolled in the study. Median age was 35 years (range, 18–59), 33% were married or living as married, 50% had an annual household income of $12,000 or less, and 56% were employed full or part time. Two women (0.13%) tested positive for HIV. In the past 12 months, 19% had been diagnosed with a sexually transmitted infection (other than HIV), 87% engaged in unprotected vaginal intercourse (UVI), and 26% engaged in unprotected anal intercourse (UAI). In multivariate analysis, UAI was significantly (p < .05) more likely among those who reported ever being pregnant, binge drinking in the past 30 days, ever exchanging sex for things needed or wanted, engaging in UVI, or being of Hispanic ethnicity. UAI was also more likely to occur with partners with whom women had a current or past relationship as opposed to casual partners.ConclusionA high percentage of our sample of heterosexually active women of color had recently engaged in sexual risk behaviors, particularly UAI. More research is needed to elucidate the interpersonal dynamics that may promote this high-risk behavior. Educational messages that explicitly address the risks of heterosexual anal intercourse need to be developed for heterosexually active women and their male partners.     

Human Physique and Sexual Attractiveness in Men and Women: A New Zealand–U.S. Comparative Study

Men and women living in New Zealand and California completed five studies regarding human physique and sexual attractiveness. In Studies 1–3, women rated images of male stimuli and, in Studies 4–5, men rated female stimuli. In Study 1, women in both countries rated mesomorphic (muscular) and average male somatotypes as most attractive, followed by ectomorphic (slim) and endomorphic (heavily built) figures. In Study 2, amount and distribution of masculine trunk hair (chest and abdominal) was altered progressively in a series of front-posed male figures. In both countries, the image lacking any trunk hair was rated as the most attractive, with a steady decline in attractiveness as hirsutism became more pronounced. Study 3 assessed attractiveness of front-posed male figures that varied only in the length of the non-erect penis. Five lengths were presented: The smallest penile size was rated as less attractive than three intermediate sizes. The largest penile size was not the most attractive, but received higher scores than the unaltered and smallest penile size. In Study 4, men rated the attractiveness of back-posed female images varying in waist-to-hip ratio (WHR) (from 0.5 to 1.0). The 0.7 WHR figure was rated more attractive in New Zealand and the 0.6 WHR in California. Study 5 measured the attractiveness of female skin color; men expressed preferences for lighter skinned female figures in New Zealand and California. Results indicate very similar preferences for sexually dimorphic physical traits among men and women of European extraction, living in two culturally and geographically different environments.     

Does the Direction of Effects in the Association Between Depressive Symptoms and Health-Risk Behaviors Differ by Behavior? A Longitudinal Study Across the High School Years

PurposeAdolescence is associated with the onset of depressive symptoms as well as significant increases in health-risk behaviors. Potential explanations for the direction of effects in the association between depressive symptoms and health-risk behaviors include the self-medication/acting out hypothesis (i.e., early depressive symptoms predict increases in risk behaviors over time) and the failure hypothesis (i.e., early participation in health-risk behaviors predicts increases in depressive symptoms over time). The purpose of the present longitudinal study was to assess these competing hypotheses across the high school years, and to examine whether the direction of effects (and therefore the self-medication/acting out and failure hypotheses) may differ depending on the type of risk behavior under consideration.MethodsThe sample consisted of 4,412 adolescents (49% female) who were followed up from grade nine to 12. Adolescents reported on their depressive symptoms and six health-risk behaviors (frequency of alcohol use, amount of alcohol consumed per drinking episode, cigarette smoking, marijuana use, hard drug use, and delinquency). Analyses were conducted with dual trajectory growth curve modeling.ResultsAdolescents who had higher depressive symptoms in grade nine reported faster increases than their peers in smoking, marijuana, and hard drug use across the high school years, supporting the self-medication hypothesis. The failure hypothesis was not supported.ConclusionThe results are important because they suggest that by targeting depressive symptoms during early adolescence, treatment programs may prevent increases in the frequency of these risk behaviors later in adolescence.     

Outbreak of Pulmonary Tuberculosis in a Chinese High School, 2009–2010

Background

In February 2009, a high school student was diagnosed with sputum-smear positive pulmonary tuberculosis (TB). One year later, 2 other students in the same grade developed sputum-smear positive TB.

Methods

We used tuberculin skin testing (TST), chest radiography, sputum smear, and symptomatology for case identification. We defined latent TB infection (LTBI) as a TST induration of 15 mm or larger, probable TB as a chest radiograph indicative of TB plus productive cough/hemoptysis for at least 2 weeks or TST induration of 15 mm or larger, and confirmed TB as 2 or more positive sputum smears or 1 positive sputum smear plus a chest radiograph indicative of TB.

Results

Of students in the same grade as the primary case-student, 26% (122/476) had LTBI and 4.8% (23/476) had probable/confirmed TB. Of teachers, 43% (18/42) had LTBI and none had probable/confirmed TB. Sharing a classroom with the primary case-student increased risk for LTBI (rate ratio = 2.5; 95% CI: 1.9–3.4) and probable/confirmed TB (rate ratio = 17, 95% CI: 7.8–39). Of students with LTBI in February 2009 who refused prophylaxis, 50% (11/22) had probable/confirmed TB in April 2010.

Conclusions

This TB outbreak was likely started by delayed diagnosis of TB in the case-student and was facilitated by lack of post-exposure chemoprophylaxis. Post-exposure prophylaxis is strongly recommended for all TST-positive students.Key words: epidemiology, outbreak, students, tuberculosis     

Is Long-Acting Reversible Contraceptive Use Increasing? Assessing Trends Among U.S. College Women, 2008–2013

Objective To assess LARC use trends among college women (18–24 years) and identify groups that have increased LARC use. Methods Data were extracted from the National College Health Assessment-II (NCHA-II) fall 2008–2013 surveys. Logistic regression statistics were used to assess LARC use. Results Although LARC use increased from 2008 to 2013 (aOR?=?2.62; 95% CI 2.23–3.07), less than half of the sample (44%) reported using contraception at last vaginal sex. Only 2.5% of college women in this study reported using a LARC method; of LARC users, 90% reported using an intrauterine device. Nearly all sociodemographic factors were significantly associated with increases in LARC use including: age, sexual orientation, and insurance status. Conclusions LARC use significantly increased among college women. However, less effective methods such as condoms and short-acting reversible contraceptives are used more frequently. Promoting LARC use for women who desire to effectively prevent pregnancy can reduce unintended pregnancy and improve health outcomes for women while in college. Future work should examine the importance of individual and lifestyle factors that influence college women’s decision to choose a LARC method and seek to eliminate barriers to college women choosing a contraceptive method they believe works best for them.