1
|
Belachew TB, Negash WD, Belay DG, Aragaw FM, Asratie MH, Asmamaw DB. Emergency contraceptive knowledge and associated factors among abortion experienced reproductive age women in Ethiopia: a multilevel analysis using EDHS 2016 data. BMC Pregnancy Childbirth 2023; 23:775. [PMID: 37946102 PMCID: PMC10634145 DOI: 10.1186/s12884-023-06091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Emergency contraceptives (EC) are used to avoid unintended pregnancy, hence avoiding its incidence and its effects. In Ethiopia, emergency contraception is commonly accessible, especially in the big cities. However, there is virtually little understanding of or awareness of EC and Ethiopia has a high abortion rate. Therefore this study was aimed to assess the magnitude and associated factors for emergency contraceptive knowledge in Ethiopia. METHODS The study was based on secondary data analysis of the Ethiopian Demographic and Health Survey 2016 data. A total weighted sample of 1236 reproductive age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of emergency contraceptive knowledge. Statistical significance was determined using Adjusted Odds Ratio (AOR) with 95% confidence interval. RESULTS Overall magnitude of emergency contraceptive knowledge was observed to be 17.19% (95% CI: 15.18, 19.40) with intra-class correlation (ICC) 57% and median odds ratio (MOR) 6.4 in the null model. Women's age 25-34 (AOR = 2.6; 95% CI: 1.2, 5.5), and 35-49 (AOR = 1.5; 95% CI: 1.06, 3.3), secondary and above educational level (AOR = 3.41; 95% CI: 2.19, 4.88), media exposure (AOR = 2.97; 95% CI: 1.56, 5.64), Being in metropolitan region (AOR = 2.68; 95% CI: 1.46, 4.74), and women being in urban area (AOR = 3.19; 95% CI: 1.20, 5.23) were associated with emergency contraceptive knowledge. CONCLUSION Emergency contraceptive knowledge in this study was low. Women age, educational level, media exposure, residency, and region were significantly associated with emergency contraceptive knowledge. Therefore, to enhance understanding and use of ECs in the current Ethiopian setting, it is imperative to ensure exposure to EC information, particularly in rural regions.
Collapse
Affiliation(s)
- Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women's and Family health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
2
|
Panda S, Das R, Das A, Sharma N, Sharma A. A study to assess the knowledge and awareness among young doctors about emergency contraception. J Family Med Prim Care 2021; 10:2304-2312. [PMID: 34322429 PMCID: PMC8284221 DOI: 10.4103/jfmpc.jfmpc_2439_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/21/2021] [Accepted: 03/17/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Emergency contraception (EC) is the contraception on demand which can prevent millions of unintended pregnancies. The knowledge and awareness of young doctors towards EC who may be the first contact physician of the society has not been well studied. This study aims to assess the knowledge and awareness of young doctors in a teaching institute in northeast India. Methodology: This study was carried out among 200 young doctors and included 100 interns and 100 postgraduate trainees (PGT) and senior resident doctors (SRD) from January 2020 to March 2020 to compare their knowledge and awareness about EC. A predesigned self-administered 22 items questionnaire was used to collect data. Observation: In our study, majority of the doctors in both groups were aware of levonorgestrel 1.5 mg tablet as EC (93% and 95%) and more interns than PG SRD were aware of its easy availability (86%, 35%, P value < 0.0001), government supply (77%, 30%, P value < 0.0001), and that copper intrauterine contraceptive device (IUCD) can be used as EC up to 120 h (89%, 60%, P value < 0.0001). Most doctors were unaware of ulipristal acetate. Most PGT SRDs believe that EC promotes irresponsible behavior, sexually transmitted diseases, and promiscuity but most intern did not agree to it (P value < 0.0001 for each). More than 65% doctors in both groups were aware of the mechanism of action of EC. PGT SRD were more aware of the effectiveness of EC (62%, 80%, P value 0.0078). More interns were aware that EC affects the next period (53%, 25%, P value < 0.0001). Conclusion: Interns were more aware about contraception than PGT and SRD, especially about government supply of EC, about IUCD, and behavioral aspect like promoting irresponsible behavior, sexually transmitted disease, and promiscuity.
Collapse
Affiliation(s)
- Subrat Panda
- Department of Obstetrics & Gynaecology, NEIGRIHMS, Meghalaya, India
| | - Rituparna Das
- Department of Obstetrics & Gynaecology, NEIGRIHMS, Meghalaya, India
| | - Ananya Das
- Department of Obstetrics & Gynaecology, NEIGRIHMS, Meghalaya, India
| | - Nalini Sharma
- Department of Obstetrics & Gynaecology, NEIGRIHMS, Meghalaya, India
| | - Anusuya Sharma
- Department of Obstetrics & Gynaecology, NEIGRIHMS, Meghalaya, India
| |
Collapse
|
3
|
Guleria S, Munk C, Elfström KM, Hansen BT, Sundström K, Liaw K, Nygård M, Kjaer SK. Emergency contraceptive pill use among women in Denmark, Norway and Sweden: Population‐based survey. Acta Obstet Gynecol Scand 2020; 99:1214-1221. [DOI: 10.1111/aogs.13849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/22/2020] [Accepted: 03/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Sonia Guleria
- Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
| | - Christian Munk
- Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
| | - K. Miriam Elfström
- Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
| | - Bo T. Hansen
- Department of Research Cancer Registry of Norway Oslo Norway
| | - Karin Sundström
- Department of Laboratory Medicine Karolinska Institutet Stockholm Sweden
| | - Kai‐Li Liaw
- Epidemiology Merck Research Laboratories North Wales PA USA
| | - Mari Nygård
- Department of Research Cancer Registry of Norway Oslo Norway
| | - Susanne K. Kjaer
- Virus, Lifestyle and Genes Danish Cancer Society Research Center Copenhagen Denmark
- Department of Gynecology Rigshospitalet University Hospital University of Copenhagen Copenhagen Denmark
| |
Collapse
|
4
|
Davis P, Sarasveni M, Krishnan J, Bhat LD, Kodali NK. Knowledge and attitudes about the use of emergency contraception among college students in Tamil Nadu, India. JOURNAL OF THE EGYPTIAN PUBLIC HEALTH ASSOCIATION 2020; 95:1. [PMID: 32813100 PMCID: PMC7366310 DOI: 10.1186/s42506-019-0030-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/15/2019] [Indexed: 12/03/2022]
Abstract
Background In India, a large number of pregnancies are unplanned resulting in unsafe and illegal abortion. For every legal abortion, 10 to 11 illegal abortions are occurring which endangers the health and survival of the women. In recent years, there is an increase in unwanted and unintended pregnancy at the early age group. Usage of emergency contraception (EC) can decrease the unwanted pregnancy and provide a healthier life. Aim The aim of study is to assess the knowledge and attitude regarding EC among college students in Thiruvarur District, Tamil Nadu, India. Methods A cross-sectional study was conducted among the college students of Thiruvarur district, Tamil Nadu, India. A total of 758 students were selected by convenient sampling technique. Data was collected by administering a pretested semi-structured questionnaire. Results Out of 758 students, 183(24%) heard about EC. The commonest source of information was the internet 91 (49.7%). The majority 116 (63.4%) knew that it does not prevent STDs. Of those who were aware, 42% were aware of 42.6% are aware of the time limit to use EC. The knowledge level of about the EC was moderate (60.1%), and it was significantly (p < 0.05) more among students > 25 years old, married participants, students in private institution, of lower socio-economic status, Muslim students and days’ scholars. The negative attitude towards EC was 59%. Nearly 38.8% believed that the EC will affect the next menstrual period, and 35.5% informed it will increase high risk behaviour among adults. The attitude level was significantly associated with the same factors associated with the awareness level with the factors Christian religion replacing Muslim and higher socioeconomic class replacing lower class participants. Conclusion The knowledge level of the studied college students was moderate, and they mostly had negative attitude towards the EC. Reproductive health education should be given in educational institutions to promote awareness and to remove misconceptions about EC.
Collapse
Affiliation(s)
- Prem Davis
- Health Centre, Central University of Tamil Nadu, Thiruvarur, 610005, India.
| | | | - Jayalakshmi Krishnan
- Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Lekha Diwakara Bhat
- Department of Epidemiology & Public Health, Central University of Tamil Nadu, Thiruvarur, India
| | - Naveen Kumar Kodali
- Department of Epidemiology & Public Health, Central University of Tamil Nadu, Thiruvarur, India
| |
Collapse
|
5
|
Jiménez-Iglesias A, Moreno C, García-Moya I, Rivera F. Prevalence of emergency contraceptive pill use among Spanish adolescent girls and their family and psychological profiles. BMC WOMENS HEALTH 2018; 18:67. [PMID: 29769104 PMCID: PMC5956739 DOI: 10.1186/s12905-018-0560-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/01/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Adolescent girls' family context and psychological characteristics play important roles in their sexual behavior, including the use of the emergency contraceptive pill (ECP). This study aims to (1) determine the prevalence of ECP use among girls who have had sexual intercourse and (2) comparatively analyze their family and psychological profiles according to whether they have used ECPs. METHODS The sample of 1735 Spanish girls aged 15 to 18 came from a representative sample of the 2014 edition of the Health Behaviour in School-aged Children (HBSC) study. Of this sample, 398 girls had sexual intercourse and reported their ECP use. Data collection for the HBSC study was performed through an online questionnaire to which adolescents responded anonymously in school. Data analyses were descriptive and bivariate and were performed with the statistical program IBM SPSS Statistics 23. RESULTS The results demonstrated that 30.65% of girls who had sexual intercourse used ECPs. Noticeable differences in paternal knowledge and communication with the father were observed between girls who used the ECP at least once and those who did not use it. In contrast, differences between girls who used the ECP once and those who used it twice or more were pronounced with regard to parental knowledge, communication with parents, maternal affection, life satisfaction, sense of coherence and depression. CONCLUSIONS This work demonstrates a high prevalence of ECP use and a more positive family and psychological profile for girls who used ECP once compared with those who used it twice or more.
Collapse
Affiliation(s)
- Antonia Jiménez-Iglesias
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, C/ Camilo José Cela, s/n, 41018, Sevilla, Spain.
| | - Carmen Moreno
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Sevilla, C/ Camilo José Cela, s/n, 41018, Sevilla, Spain
| | - Irene García-Moya
- CRIPACC, School of Health and Social Work, University of Hertfordshire, Hatfield, UK
| | - Francisco Rivera
- Departamento de Psicología Experimental, Universidad de Sevilla, Sevilla, Spain
| |
Collapse
|
6
|
Osa-Izeko O, Govender RD, Ross AJ. Self-reported knowledge and use of emergency contraception among women presenting for termination of pregnancy. S Afr Fam Pract (2004) 2016. [DOI: 10.1080/20786190.2016.1223797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
7
|
Babatunde OA, Ibirongbe DO, Omede O, Babatunde OO, Durowade KA, Salaudeen AG, Akande TM. Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria. Pan Afr Med J 2016; 23:74. [PMID: 27217897 PMCID: PMC4862801 DOI: 10.11604/pamj.2016.23.74.8688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/27/2016] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Unintended pregnancy and unsafe abortion pose a major reproductive health challenge to adolescents. Emergency contraception is safe and effective in preventing unplanned pregnancy. The objective of this study was to assess the student's knowledge and use of emergency contraception. METHODS This cross-sectional study was carried out in Ilorin, Nigeria, using multi-stage sampling method. Data was collected using pre-tested semi-structured self-administered questionnaire. Knowledge was scored and analysed. SPSS version 21.0 was used for data analysis. A p-value <0.05 was considered statistically significant. RESULTS 27.8% of the respondents had good knowledge of emergency contraception. Majority of respondents (87.2%) had never used emergency contraception. Majority of those who had ever used emergency contraception (85.7%) used it incorrectly, using it more than 72 hours after sexual intercourse (p=0.928). CONCLUSION Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents.
Collapse
Affiliation(s)
| | | | - Owen Omede
- Department of Community Medicine, Federal Medical Center, Ido-Ekiti, Nigeria
| | | | | | | | | |
Collapse
|
8
|
Chofakian CBDN, Borges ALV, Sato APS, Alencar GP, Santos OAD, Fujimori E. Does the knowledge of emergency contraception affect its use among high school adolescents? CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000100703. [DOI: 10.1590/0102-311x00188214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception) influences the method’s use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307). Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.
Collapse
|
9
|
Heywood W, Patrick K, Smith AMA, Pitts MK. Associations between early first sexual intercourse and later sexual and reproductive outcomes: a systematic review of population-based data. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:531-69. [PMID: 25425161 DOI: 10.1007/s10508-014-0374-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 02/13/2014] [Accepted: 03/24/2014] [Indexed: 05/12/2023]
Abstract
The assumption that early sexual debut leads to adverse outcomes has been used as justification for sexual health interventions and policies aimed at delaying sexual initiation, yet research in the area has been limited. This review identified and synthesized published literature on the association between early first sexual intercourse and later sexual/reproductive outcomes. Literature searches were conducted in Medline, Embase, PsycINFO, and Current Contents. In all, 65 citations met the selection criteria (industrialized, population-based studies). By far the most common sexual behavior to have been investigated has been sexual partners. Studies consistently reported early first intercourse to be associated with more recent, lifetime, and concurrent sexual partners. Early initiators were also more likely to participate in a wider range of sexual practices and report increased sexual satisfaction (among men). Furthermore, early first intercourse, in some studies, was shown to increase the risk of teen pregnancies, teen births, and having an abortion, while findings on STIs and contraceptive use have been mixed. These findings, however, must be interpreted with caution due to methodological problems and limitations present in the research, including a lack of consensus on what constitutes early sexual intercourse and inconsistencies and problems with analyses.
Collapse
Affiliation(s)
- Wendy Heywood
- Australian Research Centre in Sex, Health & Society, La Trobe University, 215 Franklin St., Melbourne, VIC, 3000, Australia,
| | | | | | | |
Collapse
|
10
|
Donadiki EM, Jimenez-Garcıa R, Velonakis EG, Hernandez-Barrera V, Sourtzi P, Lopez de Andres A, Jimenez-Trujillo I, Pino CG, Carrasco-Garrido P. Factors related to contraceptive methods among female higher education students in Greece. J Pediatr Adolesc Gynecol 2013; 26:334-9. [PMID: 24075084 DOI: 10.1016/j.jpag.2013.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 06/14/2013] [Accepted: 06/17/2013] [Indexed: 10/26/2022]
Abstract
STUDY OBJECTIVE We aimed to determine the prevalence of contraceptive methods and identify factors associated with the use of contraception by Greek female higher education students. DESIGN Cross-sectional epidemiologic survey on the factors determining the use of contraception among higher educational students. SUBJECT 3,624 female students between 18 and 26 years of age. MAIN OUTCOME MEASURES We used primary individualized data drawn from a survey carried among female college students in Greece. The dependent dichotomous variables were the responses "YES" or "NO" to the question: "During the last 12 months, what contraceptive method have you generally used in your sexual intercourses?" The methods were male condoms, oral contraceptive use (OCs) and emergency contraception (EC). The independent variables which were analysed in this survey were socio-demographic characteristics, variables related to lifestyle and variables associated with sexual habits. RESULTS Condom was the most widely used (53.87%). The variables associated independently and significantly with a greater likelihood of the use of condoms were condom use at first sexual intercourse, occupational status and higher educational level of parents. As for OCs, those who had relationship, had more than 2 sexual lifetime partners and had ever visited gynecologist (OR 6.40; 95%CI 2.80-9.40) was more likely to use. For the use of EC, those who were older, had relationship, were smokers and had more than 2 sexual lifetime partners (OR 2.15; 95%CI 1.75-2.64), was more likely to use this method. CONCLUSIONS Condom is the most used contraceptive method among female higher educational students in Greece, followed by EC. The variable most strongly associated with use of the OCs was a gynecologist visit. The factors associated with use of EC were having more than 2 sexual partners, smoking, and having a stable sexual partner.
Collapse
Affiliation(s)
- Elisavet M Donadiki
- Department of Public Health, University of Athens, Faculty of Nursing, Athens, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Koyama A, Hagopian L, Linden J. Emerging options for emergency contraception. CLINICAL MEDICINE INSIGHTS. REPRODUCTIVE HEALTH 2013; 7:23-35. [PMID: 24453516 PMCID: PMC3888080 DOI: 10.4137/cmrh.s8145] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.
Collapse
Affiliation(s)
- Atsuko Koyama
- Department of Pediatric Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Laura Hagopian
- Department of Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Judith Linden
- Department of Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| |
Collapse
|
12
|
Lo SST, Ho PC. Changes in contraceptive choice after emergency contraception. Int J Gynaecol Obstet 2012; 118:223-6. [PMID: 22727056 DOI: 10.1016/j.ijgo.2012.04.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 04/14/2012] [Accepted: 05/22/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether women use emergency contraception (EC) repeatedly instead of regular contraception methods if they have access to EC. METHODS Data from the records of 9201 women who underwent EC 11014 times in the years 2006 through 2008 at Hong Kong clinics were retrospectively analyzed. The χ(2) test was used to look for associations between demographic characteristics and repeated EC use and the Wilcoxon signed rank test was used to compare the significance of changes in contraceptive use over time. RESULTS A total of 10845 courses of EC pills and 168 intrauterine devices were provided to the 9201 women, 89.4% of whom used EC once and 8.5% twice within a year. Using EC more than twice was only associated with unstable relationships. The percentages of women using no contraceptives during intercourse decreased from 20.6% at baseline to 4.7% four to 6 weeks after EC, 4.0% at 6 months, and 3.4% at 12 months. The percentages of women using highly effective methods of contraception increased from 3.5% to 20.8%, 27.3%, and 27.7% at the same time points. CONCLUSION The low rate of repeated EC use and the positive changes in contraceptive choice after EC are reassuring.
Collapse
Affiliation(s)
- Sue S T Lo
- Family Planning Association of Hong Kong, Hong Kong.
| | | |
Collapse
|
13
|
Samartzis EP, Merki-Feld GS, Seifert B, Kut E, Imthurn B. Six years after deregulation of emergency contraception in Switzerland: Has free access induced changes in the profile of clients attending an emergency pharmacy in Zürich? EUR J CONTRACEP REPR 2012; 17:197-204. [DOI: 10.3109/13625187.2012.661108] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
14
|
Laurence V, Rousset-Jablonski C. Contraception and Cancer Treatment in Young Persons. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 732:41-60. [DOI: 10.1007/978-94-007-2492-1_4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
15
|
Unprotected Sexual Intercourse and Unplanned Pregnancy Experience of Turkish University Students. SEXUALITY AND DISABILITY 2010. [DOI: 10.1007/s11195-010-9186-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
Tsitsika A, Greydanus D, Konstantoulaki E, Bountziouka V, Deligiannis I, Dimitrakopoulou V, Critselis E, Tounissidou D, Tsolia M, Papaevagelou V, Constantopoulos A, Kafetzis D. Adolescents dealing with sexuality issues: a cross-sectional study in Greece. J Pediatr Adolesc Gynecol 2010; 23:298-304. [PMID: 20493739 DOI: 10.1016/j.jpag.2010.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2009] [Revised: 03/08/2010] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
Abstract
STUDY OBJECTIVE To evaluate the prevalence of sexual activity and contraception methods used by Greek adolescents. To assess the effect of various factors in the decision making on sexual activity. DESIGN A cross-sectional study design was applied. SETTING-PARTICIPANTS: The population (N = 1538) consisted of a random sample, stratified according to locality and population density, of 20 public junior high and high schools located in the urban district of Athens, Greece. INTERVENTIONS Anonymous self-completed questionnaires were used to assess sexual practices, contraception methods, and factors affecting sexual activity choices. MEASURES Spearman association calculations and chi-square were used, while regression analysis models were also applied. MAIN OUTCOME We examined the sexual practices among Greek adolescents, and indicated the psychosocial factors that may influence adolescents' sexual behavior. RESULTS 16% of the adolescents have had sexual intercourse, while the boy/girl ratio was 3/1 (P < 0.05). Mean age of sexual debut was 14 +/- 1.5 years. An additional 20% have had any other sexual experience at a mean age 13.5 +/- 1.5 years. Although sexually active adolescents generally use condoms (90.6%), only 32% use them properly (at every and throughout sexual contact). At least half of them do not have adequate protection (no method used or unreliable methods applied), while 8.2% of the girls have used emergency contraception. Adolescents with unstable home environment (divorce, recent death, not living with mother) or sexually experienced peers, as well as those that seek sexual education from siblings or friends have higher possibilities of being sexually active. CONCLUSION Greek adolescents can be sexually active at a young age and they need sexual education on safe sex practices.
Collapse
Affiliation(s)
- Artemis Tsitsika
- P. & A. Kyriakou Children's Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Yapici G, Oner S, Sasmaz T, Bugdayci R, Oner Kurt A. Awareness of emergency contraception among university students in Mersin, Turkey. J Obstet Gynaecol Res 2010; 36:1087-92. [DOI: 10.1111/j.1447-0756.2010.01276.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Gaudineau A, Ehlinger V, Gabhainn SN, Vayssiere C, Arnaud C, Godeau E. Use of emergency contraceptive pill by 15-year-old girls: results from the international Health Behaviour in School-aged Children (HBSC) study. BJOG 2010; 117:1197-204. [PMID: 20560940 DOI: 10.1111/j.1471-0528.2010.02637.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe emergency contraceptive pill (ECP) use and variation across countries/regions; and to explore personal and contextual factors associated with ECP use and differences across countries/regions. DESIGN Data were obtained from 11 countries/regions in the 2006 Health Behaviour in School-aged Children cross-sectional study. SETTING Data were collected by self-report questionnaire in school classrooms. POPULATION The analysis is based on 2118 sexually active 15-year-old girls. METHODS Contraceptive behaviours were compared across countries/regions by chi-square tests. Individual factors related to ECP use were investigated with separate logistic regression models. Multilevel random-intercept models allowed the investigation of individual and contextual effects, by partitioning the variance into student, school and country/region levels. MAIN OUTCOME MEASURES ECP use at last sexual intercourse. RESULTS ECP use rate varied significantly across countries/regions. Poor communication with at least one adult (odds ratio [OR] 1.62 [1.12-2.36], P = 0.011) and daily smoking (OR 1.46 [1.00-2.11], P = 0.048) were independently associated with ECP use in comparison with condom and/or birth-control pill use. Sexual initiation at 14 years or later (OR 2.02 [1.04-3.93], P = 0.039), good perceived academic achievement (OR 1.69 [1.04-2.75], P = 0.035) and daily smoking (OR 1.63 [1.01-2.64], P = 0.045) were associated with higher levels of ECP use in comparison with unprotected girls. The country-level variance remained significant in both comparisons. CONCLUSIONS These data document the large heterogeneity in rates of ECP use between countries/regions. These differences could not be explained by individual or contextual factors, and raise further questions in relation to ECP access for adolescents and their education in its appropriate use.
Collapse
Affiliation(s)
- A Gaudineau
- UMR Inserm U558, University Paul Sabatier, Toulouse, France
| | | | | | | | | | | |
Collapse
|
19
|
Lete I, Cabero L, Alvarez D, Olle C. Observational study on the use of emergency contraception in Spain: results of a national survey. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.8.4.203.209] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
20
|
Mollen CJ, Barg FK, Hayes KL, Gotcsik M, Blades NM, Schwarz DF. Assessing attitudes about emergency contraception among urban, minority adolescent girls: an in-depth interview study. Pediatrics 2008; 122:e395-401. [PMID: 18676526 DOI: 10.1542/peds.2008-0009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this work was to explore the knowledge, attitudes, and beliefs of urban, minority adolescent girls about intention to use emergency contraception pills and to identify barriers to emergency contraception pill use. PATIENTS AND METHODS We conducted an in-depth, semistructured interview study of healthy, urban-dwelling, English-speaking 15- to 19-year-old black adolescents seeking care in a children's hospital emergency department. Purposive sampling was used to recruit sexually active and nonsexually active adolescents and those with and without a history of pregnancy. Enrollment continued until saturation of key themes was achieved. Participants returned after their emergency department visit for a 1-hour interview. The interview consisted of semistructured questions based on the theory of planned behavior constructs: attitudes (including knowledge), subjective norms, and perceived behavioral control, as well as demographic data collection. Interviews were recorded and transcribed. Transcripts were coded by 2 members of the study team by using a modified grounded-theory method. RESULTS Thirty interviews were required for saturation. Mean participant age was 16.4 years; 53% reported being sexually active, and 17% reported a history of pregnancy. Specific knowledge gaps exist about emergency contraception pills, including misconceptions about the recommended time frame for taking the medication. Several major themes were noted for each of the constructs. Intention to use emergency contraception pills is affected by the conflicting attitudes that the emergency contraception pill works faster than birth control pills and that those who use emergency contraception pills are irresponsible; family and friends are important influences and have uninformed but generally supportive opinions; and adolescents have a perception of limited behavioral control because of their young age and concerns about confidentiality. CONCLUSIONS Urban, minority adolescent girls have misconceptions about emergency contraception pills, are affected by the opinions of those close to them, and express concern about specific barriers. These findings can inform specific interventions aimed at addressing the barriers to emergency contraception pill use that are of most importance to this population of young women.
Collapse
Affiliation(s)
- Cynthia J Mollen
- Division of Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
| | | | | | | | | | | |
Collapse
|
21
|
Falah-Hassani K, Kosunen E, Shiri R, Rimpelä A. Emergency contraception among Finnish adolescents: awareness, use and the effect of non-prescription status. BMC Public Health 2007; 7:201. [PMID: 17688702 PMCID: PMC1976617 DOI: 10.1186/1471-2458-7-201] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2007] [Accepted: 08/09/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents need to be aware that there is a method of preventing pregnancy even after an unprotected intercourse. Limited information is available on the awareness of young adolescents and the effects of selling emergency contraception (EC) over-the-counter, and the findings are controversial. The aims of this study were to investigate awareness and use of EC among Finnish girls aged 12-18 years in 1999-2003, and to assess the effect of the 2002 non-prescription status on the use. METHODS A self-administered questionnaire was sent to a population-based sample of 12-18-year-olds girls in 1999, 2001, and 2003. Response rate was 83% in 1999 (N = 4,369), 79% in 2001 (N = 4,024) and 77% in 2003 (N = 3,728), altogether N = 12,121. Logistic regression model was used to examine the association of unawareness and use of EC with socio-economic background and health behaviour. RESULTS In 2001, nearly all 14-18-year-olds and a majority of 12-year-olds were aware of EC. Among 12-14-year-olds, a slight increase in awareness between 1999 and 2003 was observed but this was not related to non-prescription status. Health-compromising behavior (alcohol use, smoking), dating and having good school achievement were related to higher awareness of EC.Nine percent of 14-18-year-olds had used EC once and 1% three times or more. No statistically significant change in EC use was found after non-prescription status. EC use increased with increasing alcohol consumption, particularly at age 14. Smoking, dating, and poor school achievement were related to increased use as well as not living in nuclear family. A lower use was observed if living in rural area or father's education was high. Mother's education was not related to use. CONCLUSION Adolescent girls were well aware of the existence of emergency contraception even before the non-prescription status. Over-the-counter selling did not increase the use.
Collapse
Affiliation(s)
- Kobra Falah-Hassani
- Tampere School of Public Health, University of Tampere, Tampere, Finland
- Tampere University Hospital, Tampere, Finland
| | - Elise Kosunen
- Medical School, University of Tampere, Tampere, Finland
- National Research and Development Centre for Welfare and Health (STAKES), Finland
| | - Rahman Shiri
- Tampere School of Public Health, University of Tampere, Tampere, Finland
| | - Arja Rimpelä
- Tampere School of Public Health, University of Tampere, Tampere, Finland
| |
Collapse
|
22
|
Landau SC, Tapias MP, McGhee BT. Birth control within reach: a national survey on women's attitudes toward and interest in pharmacy access to hormonal contraception. Contraception 2006; 74:463-70. [PMID: 17157103 DOI: 10.1016/j.contraception.2006.07.006] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Revised: 07/14/2006] [Accepted: 07/14/2006] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This survey was conducted to better understand women's experiences with hormonal contraception and their interest in and attitudes toward gaining direct access to oral contraception (OC), patch, ring or emergency contraception (EC) in pharmacies. METHOD A nationally representative telephone survey of 811 women aged 18-44 years who were at risk for unintended pregnancy was conducted in the United States. RESULTS It was found that 68% of women in the United States said they would use pharmacy access to OC, patch, ring and/or EC. Likely users include women not using contraception who would begin using hormonal contraceptives (41%) if they were available directly in pharmacies, and OC, patch or ring users who were interested in obtaining their method this way (66%). Over half of the women (55%) said they would be more likely to use EC if they were available directly in pharmacies. Interest in pharmacy access is higher among uninsured and low-income women. Support for pharmacy access hinges on pharmacist screening, with 63% of women agreeing that OC, patch and ring should be available without prescription if pharmacists screen women for medically safe use. CONCLUSION Most women in the United States believe that hormonal contraception should be available without prescription and would personally use pharmacy access. Seventeen to 22 million women constitute the potential market for pharmacy access to hormonal contraceptives in the United States. Women's enthusiasm for pharmacy access suggests that the pharmacy is an important site for the provision of sexual health education, screening and supplies.
Collapse
|
23
|
Laurence V, Gbolade BA, Morgan SJ, Glaser A. Contraception for teenagers and young adults with cancer. Eur J Cancer 2005; 40:2705-16. [PMID: 15571952 DOI: 10.1016/j.ejca.2004.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2004] [Revised: 08/20/2004] [Accepted: 09/02/2004] [Indexed: 11/16/2022]
Abstract
Adolescence can be an extremely stressful time for all concerned. When this period is then compounded by the development of cancer, formidable and seemingly insurmountable problems may be perceived. Cancer in adolescence is relatively uncommon, with an annual incidence rate in western populations of approximately 150-200 per million. Five-year survival of patients diagnosed around 1990 exceeded 70% in the United Kingdom (UK) and United States of America (USA), and adolescents with cancer are likely to remain fertile. Further advances in therapeutic modalities are creating a generation of adolescents and young adults with cancer who can now aspire to the same sexual and reproductive activities as their healthy peers. This then raises the issue of avoidance of undesired pregnancy during and after treatment. This article aims to address the contraceptive needs of adolescents and young adults undergoing treatment for cancer.
Collapse
Affiliation(s)
- V Laurence
- Yorkshire Regional Centre for Paediatric Oncology & Haematology, St. James's University Hospital, Leeds, UK.
| | | | | | | |
Collapse
|
24
|
Aiken AM, Gold MA, Parker AM. Changes in young women's awareness, attitudes, and perceived barriers to using emergency contraception. J Pediatr Adolesc Gynecol 2005; 18:25-32. [PMID: 15749581 DOI: 10.1016/j.jpag.2004.11.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND In a 1996 survey, most young women ages 13-20 years from an urban, hospital-based clinic and a drug treatment center had inadequate awareness of emergency contraception (EC), and perceived several barriers to its use. Since that time, the FDA has approved two products for EC, media coverage has increased, and physicians have provided more counseling about EC. PURPOSE The purpose of this study is to compare the awareness, attitudes, and perceived barriers to using EC among a sample of young women from 1996 with a different sample of women from 2002. METHODS We recruited 139 young women (mean age 16.7 +/- 1.8 yrs) from the same adolescent clinic and drug treatment center as the 1996 sample. They had similar demographic characteristics, with the majority (63%) being African-American or multi-ethnic; 85% had ever been sexually active. They were interviewed using a questionnaire about their sexual and contraceptive history as well as their knowledge of and experience with EC. They then watched a 4(1/2) minute video and received a 5-minute didactic review of EC. Following the educational intervention, participants' knowledge, attitudes, and perceived barriers to using EC were assessed. The questionnaire used to guide the interviews was nearly identical to that used in 1996. RESULTS Between 1996 and 2002, the percentage of participants reporting that they had ever heard of EC grew (44% vs. 73%, P < 0.001), as well as the percentage reporting that they had ever used EC (4% vs. 13%, P = 0.02). Of those participants who had ever heard of EC, fewer 1996 participants knew where to obtain it compared to 2002 participants (78% vs. 95%, P = 0.002) and fewer 1996 participants knew the correct time limits for use (20% vs. 51%, P < 0.001). The above data were collected prior to a didactic review session about EC. After receiving information about EC, the percentage of participants reporting a positive attitude toward EC grew between 1996 and 2002 (72% vs. 96%, P < 0.001). Young women also had fewer concerns about safety and side effects in 2002. The 1996 participants were more likely to report barriers to using EC compared to the 2002 participants. In 1996, EC side effects and impact on fertility were the most commonly perceived barriers to EC use. However, in 2002 the frequency of all reported barriers decreased and cost had become the number one perceived barrier. CONCLUSION Since 1996, young women at an urban hospital-based adolescent clinic and drug treatment center increased their awareness, use, and positive attitudes towards EC, as well as decreased their perceived barriers to using EC. Educational interventions that focus on improving knowledge among younger adolescents, specifically about correct time limits and identifying ways to find affordable EC, will address the most common knowledge deficits and perceived barriers to EC use among adolescents.
Collapse
Affiliation(s)
- Allison M Aiken
- University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | | | | |
Collapse
|
25
|
Abuabara K, Becker D, Ellertson C, Blanchard K, Schiavon R, Garcia SG. As often as needed: appropriate use of emergency contraceptive pills. Contraception 2004; 69:339-42. [PMID: 15033411 DOI: 10.1016/j.contraception.2003.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2003] [Revised: 11/17/2003] [Accepted: 11/17/2003] [Indexed: 11/21/2022]
Abstract
Previous research has established that emergency contraceptive pills are safe and have the potential to reduce unintended pregnancy; however, policy makers, providers and even women themselves have expressed concern about repeat use of the method. Evidence regarding the safety, efficacy and frequency of repeat use show that the method is safe and effective, even when used multiple times. Reported rates of repeat use are actually lower than would be expected, and needed, based on the frequency of unprotected intercourse and contraceptive failure reported in most countries. Healthcare providers should encourage use of emergency contraceptive pills as a backup after recognizable failure of barrier methods or other hormonal contraceptive methods, and should expect that women may need emergency contraceptive pills multiple times during their reproductive years.
Collapse
Affiliation(s)
- Katrina Abuabara
- The Population Council, Panzacola No. 62, Int. 102, Colonia Villa Coyoacan, 04000, Mexico City, Mexico.
| | | | | | | | | | | |
Collapse
|
26
|
Camp SL, Wilkerson DS, Raine TR. The benefits and risks of over-the-counter availability of levonorgestrel emergency contraception. Contraception 2004; 68:309-17. [PMID: 14636933 DOI: 10.1016/j.contraception.2003.08.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Removing the prescription requirement for Plan B will help ensure that the product plays a larger role nationally in the reduction of unintended pregnancy and abortion-important public health goals. Over-the-counter (OTC) sale of Plan B should present no serious safety issues. OTC consumers are able to understand and follow the instructions for proper use of Plan B. Efficacy of the OTC product is likely to be the same as, or better than, the prescription product, given more timely access to treatment. Based on the results of a growing body of literature and foreign marketing experience, the risk of unintended health consequences also appears to be minimal. There is no evidence to suggest that American women will abuse Plan B as an OTC product.
Collapse
Affiliation(s)
- S L Camp
- Women's Capital Corporation, 1990 M Street NW, Suite 250, Washington, DC 20036, USA
| | | | | |
Collapse
|
27
|
Nguyen L, Bianchi-Demicheli F, Lüdicke F. Women's knowledge and opinions of emergency contraception. Int J Gynaecol Obstet 2003; 82:229-30. [PMID: 12873790 DOI: 10.1016/s0020-7292(03)00194-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- L Nguyen
- Department of Obstetrics and Gynaecology, University Hospital Geneva, Geneva, Switzerland
| | | | | |
Collapse
|