Abstract
Objective. The objective of this study was to evaluate the effect of an intervention with advance provision of emergency contraceptive pills (ECP), condoms, and extended information to a targeted group of teenage girls, compared with a control group, 12 months after intervention.Material and methods. A randomized controlled trial among 420 girls, 15–19 years old, requesting emergency contraception at a youth clinic in Sweden was carried out. Data were collected by a questionnaire at the initial visit and structured telephone interviews 12 months after enrolment. Differences between the intervention group and the control group regarding ECP use, time interval from unprotected intercourse to ECP intake, contraceptive use, and sexual risk-taking were analysed.Results. One year after the intervention 62% of the girls could be reached for follow-up. The girls in the intervention group reported a shorter time interval (mean 15.3 hours) from unprotected intercourse to ECP intake compared to the control group (mean 25.8 hours) (p = 0.019), without any evidence of decreased use of contraceptives or increased sexual risk-taking.Conclusion. Even up to 12 months following the intervention, advance provision of ECP at one single occasion, to a specific target group of adolescent girls, shortens the time interval from unprotected intercourse to pill intake, without jeopardizing contraceptive use or increasing sexual risk-taking. Considering the clinical relevance of these results, we suggest that advance provision of ECP could be implemented as a routine preventive measure for this target group.
Highlights
A single-dose administration of levonorgestrel 1.5 mg is the most widely used emergency contraceptive pill (ECP) worldwide
By directing the intervention to a special group, at high risk for unintended pregnancies, our aim was to evaluate if this one-dose advance supply of ECP would make any difference in time frames for ECP intake, contraceptive use, and sexual risk-taking behaviour
The most important finding was that even with this limited intervention, a difference between the groups in the time interval from unprotected intercourse to ECP intake was still notable after 1 year
Summary
A single-dose administration of levonorgestrel 1.5 mg is the most widely used emergency contraceptive pill (ECP) worldwide. Despite few side effects and increased sale statistics, the method has not yet met the expectations regarding reduced abortion rates, especially among teenagers, that many had hoped for [1]. ECP is recommended to be taken as soon as possible after unprotected intercourse; obstacles for prompt use are many, including: underestimation of pregnancy risk, limited knowledge, worries about side effects, high cost, cultural barriers, and restricted availability. Advance provision of ECP is a costeffective method that has the potential to prevent unintended pregnancies [4]. Most international studies are concordant; women provided with an advance provision of ECP use them to a greater extent and more rapidly after unprotected intercourse without engaging in increased sexual risk-taking behaviour [5,6]
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