167-172 Kuiper

However, the popularity of the method, which was initially very high, has declined precipitously.8 Sales of the device fell from 800 per day in the first quarter of 1994 to about 60 per day in April 1995; the U. S. distributor speculated that “adverse publicity and negative word-of-mouth” drove the decline.9 While both the IUD and oral contraceptives have suffered declines in use attributed to negative publicity,10 no other reliable, highly acceptable method has so rapidly developed as negative a reputation as the implant. To better understand this paradox, we undertook a qualitative study of the factors that influence implant decision-making for urban adolescents who use contraceptives and access county health facilities. In exploring the first paradox, we discovered a second one: The very teenagers who might benefit most from the contraceptive protection of the implant, and the ones targeted by family planning clinics, may be unlikely to select it.