Article

The Effect of Increased Access to Emergency Contraception Among Young Adolescents

Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
Obstetrics and Gynecology (Impact Factor: 5.18). 10/2005; 106(3):483-91. DOI: 10.1097/01.AOG.0000174000.37962.a1
Source: PubMed

ABSTRACT

The United States Food and Drug Administration cited an absence of data on young adolescents as the reason the emergency contraceptive, Plan B, could not be moved over-the-counter. This study analyzed data on young adolescents with increased access to emergency contraception.
We conducted an age-stratified analysis with previously published data from a randomized, controlled trial of Plan B with a sample size of 2,117, including 964 adolescents, 90 of whom were aged younger than 16 years. Participants were randomly assigned to nonprescription pharmacy access, advance provision of 3 packs, or clinic access (control). We measured contraceptive and sexual risk behaviors at baseline and 6-month follow-up and tested for pregnancy and sexually transmitted infections. We used contingency table and logistic regression analysis to measure the effect of the intervention on risk behaviors in young adolescents (< 16 years), compared with middle adolescents (16-17 years), older adolescents (18-19 years), and adults (20-24 years).
Adolescents aged younger than 16 years behaved no differently in response to increased access to emergency contraception (EC) from the other age groups. As with adults, EC use was greater among adolescents in advance provision than in clinic access (44% compared with 29%; P < or = .001), and other behaviors were unchanged by study arm, including unprotected intercourse, condom use, sexually transmitted infection acquisition, or pregnancy. Additionally, adolescents with increased access to EC did not become more vulnerable to unwanted sexual activity.
Young adolescents with improved access to EC used the method more frequently when needed, but did not compromise their use of routine contraception nor increase their sexual risk behavior.
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    • "Also, teens may be especially sensitive to the cost of contraception , given that they are unlikely to have their own earnings or health insurance coverage outside their parents or guardians [3]. Others argue that the availability of contraception promotes sexual risk taking and thus increases the teen birth rate by increasing pregnancy rates [4]. At an individual level, more highly educated teens are less likely to become teen parents [5]. "
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    ABSTRACT: Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates.
    Full-text · Article · Feb 2015 · Journal of Adolescent Health
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    • "For example, the evidence indicates that nonusers of contraception , as well as OTC pill users, continue to get recommended screening for cervical cancer even if they are not forced to return to see a clinician for an OCP prescription [6] [22]. Other research found that liberal access to emergency contraception did not increase sexual risk-taking among adolescents [23]. Overall, the concerns identified by respondents highlight the importance of coupling an OTC switch for an OCP formulation with an extensive informational campaign about who can use the pill, the safety and potential health benefits of pill use (along with detailed information on signs or symptoms indicating a problem that requires medical attention), how to use the pill, and the importance of condom use and screening for sexually transmitted infections and cervical cancer, among other topics. "
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    ABSTRACT: Background: A growing body of evidence indicates that over-the-counter (OTC) access to oral contraceptive pills (OCPs) is safe and effective. Study design: We performed a nationally representative survey of adult women at risk of unintended pregnancy using a probability-based online panel. In November-December 2011, 2046 eligible women completed the survey. Weighted proportions were calculated, and logistic regression was used to identify covariates associated with support for and interest in using an OTC OCP. Results: A total of 62.2% said they were strongly (31.4%) or somewhat (30.9%) in favor of OCPs being available OTC. A total of 37.1% of participants reported being likely to use OCPs if available OTC, including 58.7% of current users, 28.0% using no method and 32.7% using a less effective method. Covariates associated with a higher odds of reporting interest in using OTC OCPs were younger age; being divorced, being separated or living with a partner (versus married); being uninsured or having private insurance (versus public insurance); living in the south (versus northeast); and current use of OCPs or less effective methods, or nonuse of contraception (versus use of another hormonal method or intrauterine device). Among respondents who said they were likely to use OTC OCPs, the highest amount they were willing to pay was on average $20. Conclusions: US women are supportive of OTC access to OCPs, and many would obtain refills OTC or start using OCPs if they were available OTC.
    Full-text · Article · Apr 2013 · Contraception
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    • "For example, the evidence indicates that nonusers of contraception , as well as OTC pill users, continue to get recommended screening for cervical cancer even if they are not forced to return to see a clinician for an OCP prescription [6] [22]. Other research found that liberal access to emergency contraception did not increase sexual risk-taking among adolescents [23]. Overall, the concerns identified by respondents highlight the importance of coupling an OTC switch for an OCP formulation with an extensive informational campaign about who can use the pill, the safety and potential health benefits of pill use (along with detailed information on signs or symptoms indicating a problem that requires medical attention), how to use the pill, and the importance of condom use and screening for sexually transmitted infections and cervical cancer, among other topics. "

    Full-text · Article · Sep 2012 · Contraception
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