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1.
BMC Med Educ ; 24(1): 538, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38750476

RESUMO

BACKGROUND: Unintended pregnancy is a major public health problem in sexually active female students in Ethiopia. In higher education, female students are exposed to unprotected sex and are at risk of pregnancy, abortion, and its associated problems. OBJECTIVE: The objective of this study was to assess knowledge of female students about emergency contraceptives and determine factors associated with utilization among college female students at Bonga College of Education, Southwest Ethiopia. METHODS: The study was conducted from November 10, 2022 to May 30, 2023. All female students of Bonga College of education in all departments were included in this study purposively. Data were collected using Amharic version pretested questionnaire. Data obtained from the survey was entered into Microsoft Excel 2010 and analysed with SPSS version 20.0. Data summary was done with descriptive statistics. Logistic regression was used to measure associations between dependent and independent variables. Odds ratio was used to measure strengths of association between variables. Statistical significance was considered at 95% confidence level (CL). P-value less than 0.05 was considered significant during the analysis. RESULTS: In this study a total of 103 College female students were involved. The mean age of the respondents was 20.6 (SD ± 2.06) years. The finding showed that 31 (31.1%) female students had started sexual intercourse and among them 58.1% faced pregnancy. Among the total sexually experienced respondents, 93.5% use contraceptive methods while others 6.5% do not use. Among the total 31 study participants, 27(87.1%) started using EC. The majority of pregnancy (83.3%) was intended type whereas 16.7% was unwanted pregnancy. Regarding the general knowledge about contraceptive methods, 19(18.4%) had poor knowledge. Among the total 103 female college students, 66(64.1%) heard about emergency contraceptives. Forced sex and unprotected free sex are predicting factors that induces female students to use emergency contraceptives. Fear of discontinuing school was the main inducing factor to commit abortion. Logistic regression analysis showed that college female students whose age category above 25 years were more likely to use emergency contraceptives. Students who came from urban area are more likely to use EC than rural areas. Married female students (AOR = 2.5, 95% CI: 0.76, 8.7) were two times likely to use EC as contraceptive method. CONCLUSIONS: Female students who came from urban area use EC better than who came from rural areas. Majority of sexually active female students had good practice and knowledge of using EC but some had poor knowledge. Forced sex and free sexual practice are key determinant factors that induces to use EC. Abortion was mainly done in private clinic. Fear of discontinuing school was determinant factors identified to commit abortion. Therefore, responsible bodies should develop strategies to improve female students' reproductive health related to emergency contraceptives.


Assuntos
Anticoncepcionais Pós-Coito , Conhecimentos, Atitudes e Prática em Saúde , Estudantes , Humanos , Feminino , Etiópia , Estudos Transversais , Adulto Jovem , Estudantes/estatística & dados numéricos , Estudantes/psicologia , Adolescente , Adulto , Anticoncepção Pós-Coito/estatística & dados numéricos , Gravidez , Inquéritos e Questionários , Universidades , Gravidez não Planejada , Comportamento Contraceptivo/estatística & dados numéricos
2.
West J Emerg Med ; 25(2): 291-300, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38596932

RESUMO

Background: Despite the prevalence of sexual assault presentations to emergency departments (ED) in the United States, current access to sexual assault nurse examiners (SANE) and emergency contraception (EC) in EDs is unknown. Methods: In this study we employed a "secret shopper," cross-sectional telephonic survey. A team attempted phone contact with a representative sample of EDs and asked respondents about the availability of SANEs and EC in their ED. Reported availability was correlated with variables including region, urban/rural status, hospital size, faith affiliation, academic affiliation, and existence of legislative requirements to offer EC. Results: Over a two-month period in 2019, 1,046 calls to hospitals were attempted and 960 were completed (91.7% response rate). Of the 4,360 eligible hospitals listed in a federal database, 960 (22.0%) were contacted. Access to SANEs and EC were reported to be available in 48.9% (95% confidence interval [CI] 45.5-52.0) and 42.5% (95% CI 39.4-45.7) of hospitals, respectively. Access to EC was positively correlated with SANE availability. The EDs reporting SANE and EC availability were more likely to be large, rural, and affiliated with an academic institution. Those reporting access to EC were more likely to be in the Northeast and in states with legislative requirements to offer EC. Conclusion: Our results suggest that perceived access to sexual assault services and emergency contraception in EDs in the United States remains poor with regional and legislative disparities. Results suggest disparities in perceived access to EC and SANE in the ED, which have implications for improving ED practices regarding care of sexual assault victims.


Assuntos
Anticoncepção Pós-Coito , Delitos Sexuais , Humanos , Estados Unidos , Estudos Transversais , Serviço Hospitalar de Emergência , Inquéritos e Questionários
4.
Artigo em Inglês | MEDLINE | ID: mdl-38428278

RESUMO

The aim of our article is to discuss barriers associated with post-pregnancy contraception in Brazil during the SARS-CoV-2 (COVID-19) pandemic. Socioeconomic differences in gaining access to long-acting reversible contraceptive (LARC) methods became greater during the COVID-19 pandemic. The inadequate distribution of existing resources and the reduced capacity for elective care meant that healthcare providers in family planning had to be reallocated to respond to COVID-19 emergencies. In Brazil, 74% of the population depends on the national health service (Sistema Unico de Saúde) including for the provision of free contraception. However, the only LARC method available at the public service is the copper-intrauterine device (IUD); implants and hormonal-IUDs are not available, except at some teaching hospitals. Contraceptive sales remained unmodified during the pandemic, which shows that the majority of the population used less effective or no contraceptive methods during this time. However, sales of implants and the hormonal-IUD increased significantly, indicating the inequity of the low-income portion of the society as only the wealthy can afford these. On the other hand, there was an increase in sales of emergency contraception. The uptake of postpartum IUDs and contraceptive implants at the selected teaching hospitals in which they were available was high during the COVID-19 pandemic as they were the only methods immediately available. In conclusion, the COVID-19 pandemic increased both inequality and social differences in gaining access to contraceptives. Postpartum and immediate post abortion methods were also good strategies during the pandemic and were well accepted by the population. However, they were not offered by most services.


Assuntos
COVID-19 , Acessibilidade aos Serviços de Saúde , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Brasil/epidemiologia , Gravidez , Anticoncepção Pós-Coito , Serviços de Planejamento Familiar , Pandemias , Contracepção Reversível de Longo Prazo/estatística & dados numéricos , Anticoncepção/métodos , Fatores Socioeconômicos
5.
Stud Fam Plann ; 55(1): 61-69, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38483790

RESUMO

According to the WHO, all clients should have access to a range of contraceptive methods, including at least one short-term, one long-term, one permanent, and one emergency method of contraception. While there are data on the contraceptive method mix available for many low- and middle-income countries, there are limited data on emergency contraception (EC). This is likely due to some surveys not routinely collecting this information, how survey questions are asked, dual method use, and/or low levels of reported use of EC pill (ECP). Even with low reported use in surveys, contraceptive social marketing statistics from DKT International. show a trend in recent years of increasing product sales of ECPs. To understand a more complete scope of ECP use, we use Pakistan as a case study and analyze Pakistan's Demographic Health Survey (DHS) surveys and Pakistan's Contraceptives Logistics Management Systems. Based on commodities dispensed data for ECPs in 2021, about 0.4 percent of all married women in Pakistan use ECPs. While there is currently a small proportion of women, it is growing and the use of ECPs is not zero as indicated by the DHS. Therefore, where available, countries should review their health management information systems data alongside survey data for ECP use.


Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Pós-Coito , Sistemas de Informação Administrativa , Feminino , Humanos , Anticoncepcionais Pós-Coito/uso terapêutico , Paquistão , Anticoncepção , Anticoncepcionais
6.
FP Essent ; 538: 25-29, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38498326

RESUMO

Long-acting reversible contraceptives (LARCs) include progestin and copper intrauterine devices (IUDs) and progestin subdermal implants. LARCs may be the preferred for individuals who want a method that is highly effective and can last for several years, or for whom estrogen is contraindicated. LARCs should be offered using a shared decision-making approach, keeping in mind that historically these methods have been used coercively to control the reproductive choices of marginalized or disabled people. To ensure safe prescribing and reduce barriers to receiving LARCs, family physicians should be familiar with two evidence-based national contraceptive guidelines: the U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC) and the U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR). Information about insertion, removal, potential complications, and expected adverse effects should be included when counseling patients about LARC options. Both types of LARC IUDs can safely be used for emergency contraception if inserted within 5 days of unprotected intercourse. Several oral emergency contraception drug options also are available.


Assuntos
Anticoncepção Pós-Coito , Dispositivos Intrauterinos , Feminino , Humanos , Progestinas , Anticoncepcionais Orais , Anticoncepção
7.
Contraception ; 134: 110420, 2024 06.
Artigo em Inglês | MEDLINE | ID: mdl-38462205

RESUMO

OBJECTIVES: To understand patterns in demand for emergency contraception (EC), we characterize the sales of over-the-counter (OTC) levonorgestrel (LNG) EC in the United States from traditional retail outlets. STUDY DESIGN: We describe sales of OTC LNG EC using retail sales data aggregated from traditional retail channels, including grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets. RESULTS: Sales of OTC LNG EC doubled between 2016 and 2022 (approximately 7.2-14.8 million). CONCLUSIONS: Increasing sales of EC are consistent with increased use and use frequency of EC by those at risk of pregnancy in the United States. IMPLICATIONS: OTC LNG EC sales since 2016 exceed what national survey usage estimates would suggest, indicating that national surveys underreport EC use, those using EC purchase it somewhat frequently, and/or individuals stockpile EC for later use. The role of EC in individual contraceptive strategies, particularly as access to reproductive healthcare is restricted, warrants further study.


Assuntos
Comércio , Anticoncepção Pós-Coito , Levanogestrel , Medicamentos sem Prescrição , Levanogestrel/provisão & distribuição , Levanogestrel/administração & dosagem , Estados Unidos , Humanos , Medicamentos sem Prescrição/provisão & distribuição , Medicamentos sem Prescrição/economia , Feminino , Anticoncepção Pós-Coito/estatística & dados numéricos , Comércio/estatística & dados numéricos , Anticoncepcionais Pós-Coito/provisão & distribuição , Anticoncepcionais Pós-Coito/economia , Gravidez
8.
Am J Obstet Gynecol ; 230(6): 661.e1-661.e7, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38367756

RESUMO

BACKGROUND: Same-day start removes barriers to contraceptive initiation and may reduce the risk of unintended pregnancy. It may be appropriate for all contraceptive methods, but we lack data comparing methods. OBJECTIVE: This study aimed to assess the frequency of same-day start with 6 contraceptive methods among new contraceptive users and describe the efficacy of same-day start in terms of first-cycle pregnancy risk overall and by each method. STUDY DESIGN: Using prospective data from the HER Salt Lake Contraceptive Initiative, we identified and assessed outcomes for participants initiating a new method of contraception beyond the first 7 days of their menstrual cycle (same-day start). Enrolled participants at 4 family planning clinics in Salt Lake County, Utah between September 2015 and March 2017 received their method of choice regardless of their cycle day or recent unprotected intercourse. All participants self-reported last menstrual period data and unprotected intercourse events in the previous 2 weeks. We excluded participants who received care immediately after or within 2 weeks of abortion care. Clinical electronic health records provided information on contraceptive method initiation and use of oral emergency contraception. Participants reported pregnancy outcomes in 1-, 3-, and 6-month follow-up surveys with clinic verification to identify any pregnancy resulting from same-day initiation. The primary outcomes report the frequency of same-day start use and first-cycle pregnancy risk among same-day start users of all contraceptive methods. The secondary outcomes include frequency of and pregnancy risk in the first cycle of use among same-day start contraception users by method. We also report the frequency of unprotected intercourse within 5 days and 6 to 14 days of contraception initiation, frequency of concomitant receipt of oral emergency contraception with initiation of ongoing contraception, and pregnancy risk with these exposures. We analyzed pregnancy risk for each contraceptive method initiated on the same day and assessed the simultaneous use of oral emergency contraception. RESULTS: Of the 3568 individuals enrolled, we identified most as same-day start users (n=2575/3568; 72.2%), with 1 in 8 of those reporting unprotected intercourse in the previous 5 days (n=322/2575; 12.5%) and 1 in 10 reporting unprotected intercourse 6 to 14 days before contraceptive method initiation (n=254/2575; 9.9%). We identified 11 pregnancies among same-day start users (0.4%; 95% confidence interval, 0.2-0.7), as opposed to 1 (0.1%; 95% confidence interval, 0.002-0.6) among those who initiated contraception within 7 days from the last menstrual period. Users of oral hormonal contraception and vaginal hormonal methods reported the highest first-cycle pregnancy rates (1.0-1.2). Among same-day start users, 174 (6.8%) received oral emergency contraception at enrollment in conjunction with another method. Among the same-day start users who received emergency contraception at initiation, 4 (2.3%) pregnancies were reported. CONCLUSION: Same-day start is common and associated with a low pregnancy risk. Using the "any method, any-time" approach better meets contraceptive clients' needs and maintains a low risk of pregnancy.


Assuntos
Anticoncepção , Humanos , Feminino , Gravidez , Adulto , Estudos Prospectivos , Adulto Jovem , Adolescente , Anticoncepção/métodos , Anticoncepção/estatística & dados numéricos , Gravidez não Planejada , Anticoncepção Pós-Coito/estatística & dados numéricos , Anticoncepção Pós-Coito/métodos , Estudos de Coortes , Fatores de Tempo , Utah/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Comportamento Contraceptivo/estatística & dados numéricos
9.
Soc Sci Med ; 344: 116635, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38324975

RESUMO

Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy. This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use. Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term 'emergency contraception' was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from 'emergency' are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.


Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Pós-Coito , Masculino , Gravidez , Humanos , Feminino , Anticoncepcionais Pós-Coito/uso terapêutico , Gana , Formação de Conceito , Inquéritos e Questionários
10.
Drug Ther Bull ; 62(3): 38, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38326010

RESUMO

Overview of: Li RHW, Lo SST, Gemzell-Danielsson K, et al. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial [correction appears in Lancet 2023;402:850]. Lancet 2023;402:851-8.


Assuntos
Anticoncepção Pós-Coito , Humanos , Levanogestrel/uso terapêutico , Levanogestrel/farmacologia , Piroxicam , Método Duplo-Cego
11.
JAMA Netw Open ; 7(1): e2353672, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-38277150

RESUMO

This cross-sectional study of female emergency contraception users examines emergency contraception­related emergency department use disparities and associations with policy changes.


Assuntos
Anticoncepção Pós-Coito , Humanos , Serviço Hospitalar de Emergência , Inquéritos e Questionários
12.
Contraception ; 132: 110370, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38232940

RESUMO

OBJECTIVE: To estimate the incidence of ovulation suppression within five days of etonogestrel 68 mg implant insertion in the presence of a dominant follicle with and without same-day ulipristal acetate. STUDY DESIGN: This single site non-masked, exploratory randomized trial recruited people age 18-35 years with regular menstrual cycles, no pregnancy risk, and confirmed ovulatory function. We initiated transvaginal ultrasound examinations on menstrual day 7-9 and randomized participants 1:1 to etonogestrel implant alone or with concomitant ulipristal acetate 30 mg oral when a dominant follicle reached ≥14 mm in diameter. We completed daily sonography and serum hormone levels for up to seven days or transitioned to labs alone if sonographic follicular rupture occurred. We defined ovulation as follicular rupture followed by progesterone >3 ng/mL. We calculated point estimates, risk ratios and 95% confidence intervals for ovulation for each group. Ovulation suppression of ≥44% in either group (the follicular rupture suppression rate with oral levonorgestrel emergency contraception), would prompt future method testing. RESULTS: From October 2020 to October 2022, we enrolled 40 people and 39 completed primary outcome assessments: 20 with etonogestrel implant alone (mean follicular size at randomization: 15.2 mm ± 0.9 mm) and 19 with etonogestrel implant + ulipristal acetate (mean follicular size at randomization: 15.4 mm ± 1.2 mm, p = 0.6). Ovulation suppression occurred in 13 (65%) of etonogestrel implant-alone participants (Risk ratio 0.6 (95% CI: 0.3, 1.1), p = 0.08) and seven (37%) of implant + ulipristal acetate participants. CONCLUSIONS: Ovulation suppression of the etonogestrel implant alone exceeds threshold testing for future research while the implant + ulipristal acetate does not. IMPLICATIONS: Data are lacking on midcycle ovulation suppression for the etonogestrel implant with and without oral ulipristal acetate. In this exploratory study, ovulation suppression occurred in 65% of implant participants and 37% of implant + ulipristal acetate participants. Ovulation suppression of the implant alone exceeds threshold testing for future emergency contraception research.


Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Femininos , Norpregnadienos , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Desogestrel , Anticoncepcionais Femininos/farmacologia , Anticoncepção Pós-Coito/métodos
13.
Womens Health Issues ; 34(1): 66-71, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37563061

RESUMO

INTRODUCTION: Despite the high potential need for emergency contraception (EC) among college students, lack of accurate knowledge may decrease the likelihood of its use in this population. We examined knowledge about EC methods, potential outcomes of use, and access among college students in the United States. METHODS: We recruited college students from a listserv devoted to EC campus activism for an online survey about EC knowledge (N = 150) and conducted 24 follow-up in-depth interviews. We describe the share of respondents that correctly answered each question and provide additional context and insight from interview respondents. RESULTS: Gaps in EC knowledge were noted in our sample of college student EC activists. Awareness of different methods of EC was not universal; 38% of the sample was unaware of ulipristal acetate (ella®) and 61% was unaware of the intrauterine device inserted after intercourse as EC. Many respondents also incorrectly perceived additional barriers to acquiring EC such as minimum age or an ID requirement to purchase EC (64% and 49%, respectively). Interview respondents describe how medical providers, such as student health services and pharmacists, can pose barriers to EC access through either their actions or how college students expect they will act. CONCLUSIONS: We document several gaps in knowledge surrounding EC in college students, even in an activist sample. Additional efforts to inform students about the variety of available EC methods and address mistaken perceptions about barriers to access may allow college students to better meet their needs for EC.


Assuntos
Anticoncepção Pós-Coito , Dispositivos Intrauterinos , Feminino , Humanos , Amigos , Conhecimentos, Atitudes e Prática em Saúde , Estudantes , Inquéritos e Questionários , Universidades
14.
Contraception ; 131: 110344, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38008305

RESUMO

OBJECTIVE: To determine a 1-month pregnancy rate point estimate and 95% confidence interval for guideline-supported, same-day initiation of an etonogestrel implant plus oral levonorgestrel emergency contraception. STUDY DESIGN: In this single-arm, prospective observational study, all emergency contraception clients who presented to four Planned Parenthood Association of Utah clinics from February 2021 to March 2023 received information about oral levonorgestrel with same-day etonogestrel implant insertion. Participants were ≤35 years and reported unprotected intercourse within 5 days with negative pregnancy testing. The primary outcome measure was a 1-month home pregnancy test. We calculated the efficacy using a test of proportions with Yates continuity correction. RESULTS: A total of 160 emergency contraception clients (7.6% of 2106 approached) enrolled and 153 had 1-month pregnancy outcomes. A positive pregnancy test occurred in 2 participants resulting in an overall pregnancy rate of 1.32% (95% confidence interval 0.23%-5.19%). Ultrasound gestational dating assigned conception of the first pregnancy to 8 days before enrollment. For the second pregnancy, ultrasound dating designated conception at 5 days prior to enrollment. Limiting the efficacy rate to the single pregnancy that occurred within 5 days of unprotected intercourse, we report a pregnancy rate of 0.66% (95% confidence interval 0.03%-4.19%). CONCLUSIONS: In this observational study of emergency contraception clients selecting oral levonorgestrel with same-day etonogestrel implant, we identified a pregnancy rate within the established range of oral emergency contraception methods alone. IMPLICATIONS: Clients presenting for emergency contraception may also desire ongoing highly-effective contraception, yet current clinical guidelines serve as a barrier to same-day method initiation for the etonogestrel implant and other hormonal methods. Improving access to contraceptive method initiation will reduce the ongoing risk of unwanted pregnancy for this population. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov NCT04678817; registered 12/16/20.


Assuntos
Anticoncepção Pós-Coito , Anticoncepcionais Femininos , Feminino , Humanos , Gravidez , Anticoncepção Pós-Coito/métodos , Desogestrel , Levanogestrel , Adulto
15.
BMJ Sex Reprod Health ; 50(2): 76-82, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-37852734

RESUMO

BACKGROUND: National lockdowns in England due to COVID-19 resulted in rapid shifts in healthcare provision, including in primary care where most contraceptive prescriptions are issued. This study aimed to investigate contraception prescribing trends in primary care during the pandemic and the impact of socioeconomic deprivation. METHODS: Prescribing data were accessed from the English Prescribing Dataset for the first year of the COVID-19 pandemic (1 March 2020-28 February 2021) and the year prior (1 March 2019-29 February 2020). Data were analysed by geographical region (London, Midlands and East of England, North of England, South of England) and contraceptive type (progestogen-only pill (POP), combined oral contraception (COC), emergency hormonal contraception (EHC) and contraceptive injections). Differences in prescribing rates were calculated using Poisson regression. Pearson correlation coefficients were calculated for the Index of Multiple Deprivation (IMD) scores for each Clinical Commissioning Group (CCG) in the North East and North Cumbria (NENC). RESULTS: Contraception prescribing rates decreased overall during the COVID-19 pandemic in England (Poisson regression coefficient (ß)=-0.035), with a statistically significant (p<0.01) decrease in all four regions. Prescriptions decreased for COC (ß=-0.978), contraceptive injections (ß=-0.161) and EHC (ß=-0.2005), while POP (ß=0.050) prescribing rates increased. There was a weak positive correlation between IMD and prescribing rates in NENC (p>0.05). CONCLUSIONS: Contraception provision was impacted by COVID-19 with an overall decrease in prescribing rates. The deprivation results suggest that this may not be a significant contributing factor to this decrease. Further research is recommended to better understand these changes, and to ensure that services respond appropriately to population needs.


Assuntos
COVID-19 , Anticoncepção Pós-Coito , Humanos , Pandemias , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Inglaterra/epidemiologia , Anticoncepcionais
16.
Obstet Gynecol ; 143(2): 189-194, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37989139

RESUMO

Emergency contraception methods that also deliver ongoing contraception provide the most effective options for individuals hoping to prevent pregnancy after unprotected intercourse. Although the copper intrauterine device (IUD) provides the most effective option for emergency contraception because the device prevents pregnancy when placed before implantation and offers long-acting contraception, uptake by patients has been limited. Recently, the Society of Family Planning issued new guidance recommending the levonorgestrel IUD (LNG-IUD) as an emergency contraception option along with the copper IUD. Here, we review evidence related to this recommendation and conclude that the available data do not support use of the LNG-IUD for emergency contraception. We discuss the mechanisms of action of emergency contraception methods and how these concepts interface with the current political and social landscape of contraception and abortion care. We describe limitations of the existing evidence supporting use of the LNG-IUD as emergency contraception and highlight the critical research needed to establish the device as a highly effective method of emergency contraception.


Assuntos
Anticoncepção Pós-Coito , Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos , Gravidez , Feminino , Humanos , Levanogestrel
17.
Contraception ; 132: 110361, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38160962

RESUMO

BACKGROUND: Alabama's Human Life Protection Act (the Act) signed in 2019 became law in 2022, making provision of abortion a felony offense. OBJECTIVE: In 2020, we assessed the accessibility of emergency contraception (EC) pills in Birmingham, Alabama prior to the Act's enactment given the probable increased need for EC access due to abortion criminalization. STUDY DESIGN: Pharmacy staff were asked about availability, price, location, and identification requirements to obtain EC. RESULTS: Of 69 pharmacies, 59% had levonorgestrel EC and none had ulipristal acetate EC available. CONCLUSION: There are persistent barriers to EC accessibility that should be addressed as abortion is increasingly restricted.


Assuntos
Aborto Induzido , Anticoncepção Pós-Coito , Feminino , Gravidez , Humanos , Alabama , Anticoncepcionais Orais , Levanogestrel
19.
Ann Intern Med ; 176(12): JC140, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-38048581

RESUMO

SOURCE CITATION: Li RHW, Lo SST, Gemzell-Danielsson K, et al. Oral emergency contraception with levonorgestrel plus piroxicam: a randomised double-blind placebo-controlled trial. Lancet. 2023;402:851-858. 37597523.


Assuntos
Anticoncepção Pós-Coito , Levanogestrel , Humanos , Piroxicam , Método Duplo-Cego , Etnicidade
20.
BMJ ; 383: e077437, 2023 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-38123174

RESUMO

OBJECTIVE: To estimate the increase in sales of emergency contraception following the New Year's Eve/New Year's Day holiday. DESIGN: Time series analysis using autoregressive integrated moving average (ARIMA) model. SETTING: Traditional (that is, "bricks and mortar") retail outlets-grocery stores, drug stores, mass merchandisers, club stores, dollar stores, and military outlets-in the United States from 2016 to 2022. DATA SOURCE: Marketing data on weekly aggregated sales of items classified as emergency contraception gathered between 2016 and 2022 (n=362). On the basis of dates, weeks were classified as following the New Year holiday (n=6) or not (n=356). MAIN OUTCOME MEASURE: Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population. RESULTS: Sales of levonorgestrel emergency contraception significantly increased after the New Year holiday (0.63 (95% confidence interval 0.58 to 0.69) unit increase per 1000 women aged 15-44). Holidays that share some aspects of the elevated risks of unprotected sexual intercourse with the New Year holiday (Valentine's Day, St Patrick's Day, US Independence Day) were associated with increased sales, albeit to a lesser degree, with respective sales increases per 1000 women aged 15-44 of 0.31 (0.25 to 0.38), 0.14 (0.06 to 0.23), and 0.20 (0.11 to 0.29). Holidays without these expectations (Easter, Mother's Day, Father's Day) were not significantly associated with sales of levonorgestrel emergency contraception. CONCLUSIONS: Increased sales of emergency contraception following the New Year's holiday suggest that this period is associated with increased risks of unprotected vaginal intercourse compared with other holidays. Targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception around holidays may limit the risks associated with unprotected vaginal intercourse.


Assuntos
Anticoncepção Pós-Coito , Humanos , Estados Unidos/epidemiologia , Feminino , Levanogestrel/uso terapêutico , Férias e Feriados , Fatores de Tempo , Marketing
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