1
|
Bauzà ML, Esteva M, Molina J, Pereiró I, Ingla M, March S. Emergency contraception and risk habits in a university population. EUR J CONTRACEP REPR 2018; 23:427-433. [PMID: 30499726 DOI: 10.1080/13625187.2018.1533547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE The aim of our study was to determine the self-reported prevalence of use of emergency contraception (EC), identify factors associated with EC use, and measure the prevalence in university students of pregnancy and abortion among users and non-users of EC. METHODS A cross-sectional descriptive study of university students using a self-administered questionnaire was carried out in 2016. The main dependent variable was EC use at any time. Independent variables included sociodemographic factors and factors related to harmful habits and sexual behaviour. RESULTS The study sample consisted of 1309 students (median age 20 years). Forty per cent of participants reported using EC; condom failure was given as the main reason. Variables associated with EC use in both men and women were illegal drug consumption and having had more than 10 sexual partners. In women, other factors associated with EC use were age at first coitus and non-centrist political views. The prevalence of pregnancy was 6.5% and the prevalence of voluntary abortion was 2.9%. This prevalence was similar for men and women and for EC users and non-users. CONCLUSION EC use in university students was more likely in those who experienced contraceptive failure or used no contraception. There were differences between men and women. Those at higher risk of unplanned pregnancy were more likely to report EC use, which may explain why there was no difference in the rates of unwanted pregnancies between EC users and non-users.
Collapse
Affiliation(s)
- M L Bauzà
- a Department of Nursing and Physiotherapy , University of the Balearic Islands , Palma , Spain.,b Research Group of Balearic Islands - Cancer Preventive Activities , University Institute of Research in Health Sciences (IUNICS) , Palma , Spain
| | - M Esteva
- c Unit for Research , Primary Health Care Management , Palma , Spain.,d Balearic Islands Health Research Institute (iDisBA) , Palma , Spain
| | - J Molina
- a Department of Nursing and Physiotherapy , University of the Balearic Islands , Palma , Spain
| | - I Pereiró
- e Puerto de Sagunto II Health Centre , Primary Health Care Management , Valencia , Spain
| | - M Ingla
- f Health Promotion Agency , Palma , Spain
| | - S March
- c Unit for Research , Primary Health Care Management , Palma , Spain.,d Balearic Islands Health Research Institute (iDisBA) , Palma , Spain
| |
Collapse
|
2
|
Bauzà ML, Esteva M, Molina J, Pereiró I, Ingla M, March S. Emergency contraception and risk habits in a university population. EUR J CONTRACEP REPR 2018. [DOI: https://doi.org/10.1080/13625187.2018.1533547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- M. L. Bauzà
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
- Research Group of Balearic Islands – Cancer Preventive Activities, University Institute of Research in Health Sciences (IUNICS), Palma, Spain
| | - M. Esteva
- Unit for Research, Primary Health Care Management, Palma, Spain
- Balearic Islands Health Research Institute (iDisBA), Palma, Spain
| | - J. Molina
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - I. Pereiró
- Puerto de Sagunto II Health Centre, Primary Health Care Management, Valencia, Spain
| | - M. Ingla
- Health Promotion Agency, Palma, Spain
| | - S. March
- Unit for Research, Primary Health Care Management, Palma, Spain
- Balearic Islands Health Research Institute (iDisBA), Palma, Spain
| |
Collapse
|
3
|
Habel MA, Scheinmann R, Verdesoto E, Gaydos C, Bertisch M, Chiasson MA. Exploring pharmacy and home-based sexually transmissible infection testing. Sex Health 2015; 12:472-9. [PMID: 26409484 PMCID: PMC4809773 DOI: 10.1071/sh15031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/22/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. METHODS The study included two phases in February 2011-July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. RESULTS Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. CONCLUSIONS This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases.
Collapse
Affiliation(s)
- Melissa A. Habel
- Centers For Disease Control and Prevention, 1600 Clifton Road, Mailstop E-44, Atlanta, GA, USA
| | | | | | - Charlotte Gaydos
- Johns Hopkins University School of Medicine, 855 Wolfe Street, 530 Rangos Building, Baltimore, MD, USA
| | - Maggie Bertisch
- New York Walk-In Medical Group, 1627 Broadway, New York, NY, USA
| | - Mary Ann Chiasson
- Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, USA
| |
Collapse
|
4
|
Habel MA, Leichliter JS. Emergency contraception and risk for sexually transmitted infections among U.S. women. J Womens Health (Larchmt) 2012; 21:910-6. [PMID: 22731690 PMCID: PMC6737533 DOI: 10.1089/jwh.2011.3441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since Food and Drug Administration (FDA) licensure of emergency contraception (EC) over-the-counter (OTC) in 2006, this is the first U.S. study to use a nationally representative sample of reproductive-aged women (15-44) to explore the relationship between receipt and use of EC and sexually transmitted infection (STI)-related health services. METHODS Using a sample of 6329 women from the National Survey of Family Growth 2006-2008, we examined the relationship between lifetime EC use and recent receipt of EC and demographics, sexual behaviors, and STI-related services. Variables significant at p<0.10 in bivariate analyses were examined using multivariable logistic regression models. RESULTS Overall, 10% (704) of the sample had ever used EC. Most EC users had received EC from a family planning clinic (51%), drugstore (23%), or doctor's office (17%). In adjusted analyses, demographic factors associated with receipt of EC in the past 12 months included never married (adjusted odds ratio [AOR] 4.0) and living in a metropolitan statistical area (AOR 4.2). Women reporting multiple partners (2+) (AOR 2.4), inconsistent condom use (AOR 3.4), and having recently been tested for chlamydia (AOR 2.0) had higher odds of receiving EC in the past 12 months. Findings among women ever reporting EC use were similar, except women who had 4+ lifetime partners (AOR 2.5) and had recently received a chlamydia diagnosis (AOR 2.2) had higher odds of ever having used EC. CONCLUSIONS EC recipients were no more likely than nonrecipients to have received STI counseling or screening despite greater numbers of sex partners in the past year. This research indicates that women are accessing EC in pharmacies, which may be a missed opportunity for counseling and testing.
Collapse
Affiliation(s)
- Melissa A Habel
- Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
| | | |
Collapse
|
5
|
Obstetrician-gynecologist physicians' beliefs about emergency contraception: a national survey. Contraception 2010; 82:324-30. [PMID: 20851225 DOI: 10.1016/j.contraception.2010.04.151] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2010] [Revised: 04/27/2010] [Accepted: 04/29/2010] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although emergency contraception (EC) is available without a prescription, women still rely on doctors' advice about its safety and effectiveness. Yet little is known about doctors' beliefs and practices in this area. STUDY DESIGN We surveyed 1800 US obstetrician-gynecologists. Criterion variables were doctors' beliefs about EC's effects on pregnancy rates, and patients' sexual practices. We also asked which women are offered EC. Predictors were demographic, clinical and religious characteristics. RESULTS Response rate was 66% (1154/1760). Most (89%) believe EC access lowers unintended pregnancy rates. Some believe women use other contraceptives less (27%), initiate sex at younger ages (12%) and have more sexual partners (15%). Half of physicians offer EC to all women (51%), while others offer it never (6%) or only after sexual assault (6%). Physicians critical of EC, males and religious physicians were more likely to offer it never or only after sexual assault (odds ratios 2.1-12). CONCLUSION Gender, religion and divergent beliefs about EC's effects shape physicians' beliefs and practices.
Collapse
|
6
|
Pattern of use of emergency oral contraception among Portuguese women. ACTA ACUST UNITED AC 2010; 32:496-502. [DOI: 10.1007/s11096-010-9396-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 05/03/2010] [Indexed: 12/30/2022]
|
7
|
Sander PM, Raymond EG, Weaver MA. Emergency contraceptive use as a marker of future risky sex, pregnancy, and sexually transmitted infection. Am J Obstet Gynecol 2009; 201:146.e1-6. [PMID: 19646565 DOI: 10.1016/j.ajog.2009.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 04/03/2009] [Accepted: 05/12/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of the study was to examine whether emergency contraceptive use predicts future sex at risk for pregnancy, pregnancy, or sexually transmitted infection among young women. STUDY DESIGN A secondary analysis of control group participants (n = 718) from a recent trial of advanced provision of emergency contraception was conducted. RESULTS We found no association between use of emergency contraception and either pregnancy or infection. Recent use predicted decreased occurrence of subsequent sex at risk for pregnancy among women with a history of sexually transmitted infection (relative risk [RR], 0.39; 95% confidence interval [CI], 0.15-0.97), whereas ever having used predicted increased occurrence among women who either were highly effective method users (RR, 1.45; 95% CI, 1.05-2.01) or had no history of sexually transmitted infection (RR, 1.31; 95% CI, 1.04-1.65). CONCLUSION Information about prior emergency contraceptive use was not a useful predictor of subsequent pregnancy, infection, or sex at risk for pregnancy among these young women.
Collapse
Affiliation(s)
- Petra M Sander
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | | |
Collapse
|
8
|
Abstract
Emergency contraception (EC), also known as 'the morning after pill', or post-coital contraception, is a modality of preventing the establishment of a pregnancy after unprotected intercourse. Both a hormonal and an intrauterine form are available. Modern hormonal EC, with low side effects, was first proposed by Yuzpe in 1974. More recently, a new regimen, consisting of levonorgestrel administered alone, was introduced and found in clinical trials to be more effective (if taken as early as possible), and associated with less side effects than the Yuzpe regimen, which it has gradually replaced. The WHO developed another regimen based on the use of the selective progesterone receptor modulator (antiprogestin) mifepristone and conducted trials with different dosages. Intrauterine EC was first proposed by Lippes in 1976. It has the advantage of being applicable for almost a week and the disadvantage of a greater complexity. In addition, this modality is solely interceptive, acting by preventing implantation. Pregnancy rates reported following EC using an intrauterine device with more than 300 mm2 of copper are consistently low (0.1-0.2%).
Collapse
Affiliation(s)
- Carlo Bastianelli
- Department of Gynaecologic Sciences, Perinatology and Child Care, University la Sapienza, Rome, Italy.
| | | | | |
Collapse
|
9
|
Peremans L, Verhoeven V, Philips H, Denekens J, Van Royen P. How does a Belgian health care provider deal with a request for emergency contraception? EUR J CONTRACEP REPR 2008; 12:317-25. [PMID: 17853170 DOI: 10.1080/13625180701502377] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate how Belgian health care providers deal with a request for emergency contraception. METHOD In 2002-2003 we conducted 12 focus groups with pharmacists, general practitioners and school physicians. A skilled moderator accompanied by an observer conducted the focus groups using a semi-structured screenplay. RESULTS All these health care providers agree with the free access to emergency contraception (EC), but experience considerable frustration with regard to the practical aspects and the legal framework. General practitioners (GPs) claim to spend a lot of time on requests for EC and they are concerned about the quality of the counselling provided in pharmacies. Pharmacists are creative when giving counselling in the pharmacy, but there is, nevertheless, a problem with a lack of privacy. School physicians are frustrated that there is no legal possibility to respond to a request for EC when they feel they are ideally placed to advise adolescents. CONCLUSION The over-the-counter sale of EC offers women better access, but many barriers still interfere with optimal care. Pharmacists experience a lack of skills to communicate with adolescents and a lack of privacy to give counselling. GPs have good intentions, but are confronted with a lack of willingness on the part of the patients and also financial barriers. School physicians want more possibilities to help adolescents.
Collapse
Affiliation(s)
- Lieve Peremans
- University of Antwerp, Department of General Practice, Antwerp, Belgium.
| | | | | | | | | |
Collapse
|
10
|
Geisler WM, James AB. Chlamydial and gonococcal infections in women seeking pregnancy testing at family-planning clinics. Am J Obstet Gynecol 2008; 198:502.e1-4. [PMID: 18295177 DOI: 10.1016/j.ajog.2007.11.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2007] [Revised: 09/12/2007] [Accepted: 11/08/2007] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of the study was to assess genital chlamydia and gonorrhea prevalence and associated predictors in women seeking pregnancy testing. STUDY DESIGN The study included analysis of demographics and results of pregnancy, chlamydia, and gonorrhea testing in 1465 females seeking pregnancy testing at family-planning clinics in South Carolina. RESULTS The median age was 22 years (range 16-45), the race distribution consisted of 53% African Americans and 47% Caucasians, and 64% of subjects were pregnant. Chlamydia and gonorrhea were detected in 12% and 2% of subjects, respectively. Predictors of chlamydia and gonorrhea included younger age and African American race. Chlamydia and gonorrhea prevalence did not differ in pregnant vs nonpregnant subjects. CONCLUSION Chlamydia prevalence was high and gonorrhea prevalence low in women seeking pregnancy testing at family-planning clinics, and both were predicted by younger age and African American race but not pregnancy status. Because the majority seeking pregnancy testing were pregnant, chlamydia testing in this population at risk for chlamydia-associated morbidity has potential benefit.
Collapse
|