P2-S9.03 The sex lives of emergency contraception users in the USA, 2006–2008

• Published in: Sexually transmitted infections Vol. 87; no. Suppl 1; pp. A261 - A262
• Main Authors: Habel, M, Leichliter, J S
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.07.2011; BMJ Publishing Group LTD
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2011-050108.389

Background Previous research indicates that emergency contraception (EC) users are less likely to have visited a gynaecologist in the past 12 months, and are more likely to report ever having an STI compared to non-users; however, studies examining this unique population have been outside of the USA Given FDA-licensure of EC behind-the-counter, this is the first US study to use a nationally representative sample of reproductive aged women (15–44) to explore whether EC users represent a missed opportunity for STI counselling and screening. Methods Data were collected through in-person interviews and through audio computer-assisted self-interview. Using a sample of 7356 women, sexual behaviour variables for which there were significant bivariate differences (p<0.10) for lifetime EC users were examined in a multiple logistic regression model controlling for demographics often associated with sexual behaviour including age, race/ethnicity, marital status, poverty level, and geographic location. Results Overall 10% (704) of the sample had ever used EC; less than 3% had used it within the past 12 months. Most women had only used EC once (62%). Primary reasons for use were not using a birth control method (46%) and worry that birth control would not work (42%). Most EC users had received EC from a family planning clinic (51%). More EC users obtained EC from a drug store drug store (23%) than a private doctor's office (17%); most received EC without a prescription (69%). Demographic factors associated with lifetime EC use included: age 20-24/25-29 years (AORs=3.3; 2.4), never married (2.1), income 150% above the poverty level (1.6), and living in an urban-suburban area (1.6). Lifetime EC users were almost twice as likely to have had >4 lifetime partners. In bivariate analyses lifetime EC use was associated with receiving STI services in the past 12 months and having had a pap, but in the model became insignificant. Conclusions Contrary to previous findings, EC users were no more likely than non-users to have received STI counselling or screening, despite greater numbers of sex partners. However, with licensure of behind-the-counter ECs, this research indicates that some women are accessing ECs without a prescription at drug stores rather than a provider's office, representing a missed opportunity for screening. These findings suggest future research on EC access and possible expansion of STI screening programs into real world settings, such as pharmacies. Abstract P2-S9.03 Table 1 Prevalence of lifetime emergency contraception (EC) use n (%) SE Population total (weighted n) Ever used EC (n=6326)  Yes 704 (9.7) 0.9 5,1171,887  No 5623 (90.2) 0.9 48,055,234 Used EC in past 12 months (n=6327)  Yes 175 (2.1) 0.3 1,156,443  No 6151 (97.8) 0.9 52,068,403 No of times ever used (n=703)  1 431 (61.9) 3.6 3,180,161  2 160 (24.3) 2.4 1,248,453  3+ 112 (13.8) 3.0 709,209 Primary reasons for EC use*(n=703)  Worried birth control method would not work 271 (42.3) 4.3 2,188,726  Didn't use birth control that time 345 (45.8) 3.5 2,369,367  Other reason 87 (11.8) 1.3 610,641 Where received EC (n=449)  Private doctors/HMO 74 (16.5) 1.2 905,108  Community Clinic/FP clinic/school-based Clinic 232 (50.8) 4.3 2,228,311  Hospital facility or urgent care 29 (6.2) 1.1 342,076  Friend, partner, or spouse 13 (2.3) 0.6 123,784  Drug store 95 (23.1) 2.5 1,266,920  Other place 6 (1.0) 0.2 57,439 Obtained EC with a Rx (n=144)  Yes 49 (31.4) 2.3 764,194  No 95 (68.6) 2.3 1,645,951 * First reason mentioned for the last (or only) time used EC. †Population totals reflect US women age 15–44 years.