Table I.

Common myths affecting the use of long-acting reversible contraceptives methods in Latin America and the Caribbean.

Stakeholders	Myth	Evidence
Policymakers	LARC methods are more costly than other modern methods of contraception	LARC methods are highly cost-effective in the long term as a result of their high efficacy (Trussell, 2011; Winner et al., 2012).
HCP	There are many requirements for IUC or implant placement	The commons requirements prior to placing an IUC is to have a gynaecologic exam and that the HCP be reasonably sure a woman is not currently pregnant (WHO, 2015).
	LARC methods have low efficacy	LARC methods are top-tier contraceptives based on both efficacy and effectiveness, with pregnancy rates of less than 1 per 100 woman-years for both perfect and typical use (Trussell, 2011; Winner et al., 2012).
	Perforation risk is perceived to be greater in nulligravidas	No data show a difference in perforation risk between nulligravida and parous women (Lyus et al., 2010).
	Adolescents and young adults do not like to use LARC methods	Given the availability of no-cost contraception, ~75% of women (including adolescents) chose LARC, and continuation was significantly higher among LARC- than non-LARC users (McNicholas et al., 2015).
	Given their age, adolescents cannot decide for themselves an appropriate contraceptive method	The Convention on the Rights of the Child indicates the right to the highest level of health and access to medical services, with an emphasis on those related to primary healthcare (PAHO, 2017).
	Individuals with disabilities do not require contraceptive counselling	Prejudices associated with the sexuality and reproduction of the disabled have no bearing on their right to receive contraceptive counselling and methods (PAHO, 2017).
	Use of LARC causes osteoporosis	No significant decrease in bone mineral density has been shown following use of LARC (Bahamondes et al., 2014, 2015a).
General Public (including users, partners, relatives and general community)	The pain associated with IUC placement is enough to serve as a deterrent	The available studies used a scale of 0 (no pain) to 10 (severe pain) and showed that the majority of women rated IUC placement as 2 or less, and only 4% rated it ≥7 (Elkhouly and Maher, 2017).
	IUCs will not fit in the uterus of nulligravidas	WHO does not restrict use of IUCs on the basis of age or parity. Both parous and nulligravidas have an IUC expulsion rate of less than 5% (Secura et al., 2010; Bahamondes et al., 2015c; WHO, 2015).
	Implants and IUCs cause cancer	Neither implants nor IUCs have shown a causal relationship with gynaecologic or other cancers. Indeed, some IUCs have shown a potential protective effect against both endometrial and cervical cáncer (Castellsagué et al., 2011).
	The government encourages contraceptive use to limit minority populations	No evidence. However, HCPs must consider how women’s experiences may influence their responses to contraceptive counselling, particularly with regard to race and income (Peipert et al., 2012).
Both HCPs and General Public	IUC use causes abortions	LARCs act prior to fertilization or by changing cervical mucus (Moraes et al., 2016).
	IUC use carries a higher risk of developing PID and later infertility	After the first 20 days of placement, risk of PID is the same in both LARC users and nonusers. There is no change in fertility rates following removal of LARC (Toivonen et al., 1991; Tsanadis et al., 2002; Lyus et al., 2010; Jatlaoui et al., 2017).
	IUCs can only be placed during menstrual periods	An IUC can be safely placed at any time during the menstrual cycle (Whiteman et al., 2013).

LARC, long-acting reversible contraceptive; HCP, healthcare professionals; IUC, intrauterine contraceptive; PID, pelvic inflammatory disease; WHO, the World Health Organization.