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ORIGINAL RESEARCH |
From 1Family Health International, Research Triangle Park, North Carolina; 2University of California at San Francisco, San Francisco, California; 3University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; 4Planned Parenthood of Central North Carolina, Durham, North Carolina; 5Indiana University, Indianapolis, Indiana.
OBJECTIVE: To assess how a strategy to maximize access to emergency contraceptive pills would affect rates of pregnancy and sexually transmitted infections.
METHODS: Sexually active women, 14–24 years old, were randomly assigned to two methods of access to emergency contraceptive pills: increased access (two packages of pills dispensed in advance with unlimited resupply at no charge) or standard access (pills dispensed when needed at usual charges). Participants were followed for 1 year to assess incidence of pregnancy, gonorrhea, chlamydia, and trichomonas.
RESULTS: The numbers of women enrolled in the increased and standard access groups were 746 and 744, respectively. More than 93% of participants completed a full year of follow-up. The incidence of pregnancy was similar in both groups (increased access group: 9.9/100 woman years, 95% confidence interval [CI] 7.7–12.6; standard access group: 10.5/100 woman years, 95% CI 8.2–13.2). Aggregate rates of gonorrhea, chlamydia, and trichomonas were also similar in the two groups (increased access group: 6.9/100 woman years, 95% CI 5.1–9.1; standard access group: 7.6/100 woman years, 95% CI 5.7–9.9). The increased access group used emergency contraceptive pills substantially more often and sooner after coitus than the standard access group. No other differences were noted between groups in self-reported measures of sexual behavior and contraceptive use.
CONCLUSION: This intensive strategy to enhance access to emergency contraceptive pills substantially increased use of the method and had no adverse impact on risk of sexually transmitted infections. However, it did not show benefit in decreasing pregnancy rates.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00060463
LEVEL OF EVIDENCE: II-1
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  C. B. Polis, K. Schaffer, K. Blanchard, A. Glasier, C. C. Harper, and D. A. Grimes Advance Provision of Emergency Contraception for Pregnancy Prevention: A Meta-Analysis Obstet. Gynecol., December 1, 2007; 110(6): 1379 - 1388. [Abstract] [Full Text] [PDF]
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J. Wu, T. Gipson, N. Chin, L. L. Wynn, K. Cleland, C. Morrison, and J. Trussell Women Seeking Emergency Contraceptive Pills by Using the Internet Obstet. Gynecol., July 1, 2007; 110(1): 44 - 52. [Abstract] [Full Text] [PDF]
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 S. Kachroo Misinformation about emergency contraception Am. J. Health Syst. Pharm., June 1, 2007; 64(11): 1137 - 1142. [Full Text] [PDF]
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 More Emergency Contraception Doesn't Mean More Sex Journal Watch Pediatrics and Adolescent Medicine, February 14, 2007; 2007(214): 3 - 3. [Full Text]
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 Other articles noted Evid. Based Med., February 1, 2007; 12(1): 31 - 32. [Full Text] [PDF]
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E. G. Raymond, J. Trussell, and C. B. Polis Population Effect of Increased Access to Emergency Contraceptive Pills: A Systematic Review Obstet. Gynecol., January 1, 2007; 109(1): 181 - 188. [Abstract] [Full Text] [PDF]
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M. Gilliam Emergency contraception: politics and science move forward. Obstet. Gynecol., November 1, 2006; 108(5): 1060 - 1061. [Full Text] [PDF]
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