Emergency Contraception Research Articles

Retail demand for emergency contraception in United States following New Year holiday: time series study.

To estimate the increase in sales of emergency contraception following the New Year's Eve/New Year's Day holiday. Time series analysis using autoregressive integrated moving average (ARIMA) model. 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. 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). Weekly sales of levonorgestrel emergency contraception per 1000 women of reproductive age in the US population. 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. 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.

Are Female Undergraduates at the University of Calabar Equipped with the Knowledge, Positive Attitudes, and Effective Practices of Contraceptives?

BACKGROUND: The global challenge of rapid population growth necessitates family planning programs to address reproductive health needs and control population increase. However, unintended pregnancies, particularly among adolescents, remain a significant problem, leading to increased risks of sexually transmitted infections and unsafe abortions. In Nigeria, contraceptive use is low among youths, resulting in high incidences of induced abortions and sexually transmitted infections. Barriers such as religious beliefs, cultural factors, limited availability, personal beliefs, and fear of side effects contribute to the under-utilization of contraceptives. METHODS: A descriptive cross-sectional study was conducted among female undergraduates of the University of Calabar, Cross River State. Data was collected using a 42-item questionnaire after obtaining informed consent. Multi-stage sampling was employed, and data was analyzed with IBM SPSS version 26 using descriptive and inferential statistics. RESULTS: The mean age of respondents was 21.5 ± 2.72 years. Most participants were in their first (26.7%) or second (22.6%) level of study. 28.8% were in sexual relationships, while 71.2% were not. Approximately a quarter of respondents had experienced symptoms of sexually transmitted infections. 71.5% had no knowledge of emergency contraception. Condoms (71.2%) and pills (54.5%) were the most commonly mentioned methods of contraception, while tubal ligation was the least popular (4.7%). The main benefit cited for contraception was the prevention of unwanted pregnancy (92.2%). 47.3% had no idea about the side effects of contraception, with irregular menstruation being the most commonly mentioned side effect (19.3%). Friends/peers, the internet, and school were the primary sources of information on contraception. 56.4% believed that contraception is not solely for females and should not be reserved for the literate. Over a third of respondents thought contraception encourages promiscuity and has too many side effects, with more than half demanding contraceptive services on campus. Less than half of the respondents (43.9%) reported using contraception at some point, with even smaller percentages using contraception in the last six months (25.2%) or during their last sexual intercourse (23.8%). Of the 101 who used contraceptives in their last sexual intercourse, the majority (83%) used condoms, while pills (7%) and emergency contraception (10%) were less common. Preferred sources for contraception were pharmacies (57.5%) and chemist shops/patent medicine vendors (24.7%). Religion (41.5%), fear of side effects (34.9%), and partner consent (28.3%) were the main influences on contraceptive use. Several factors were significantly associated with contraception utilization, including age, partner's educational level, knowledge of contraception, and level of study (p<0.05). CONCLUSION: The low utilization of contraception among female undergraduates at the University of Calabar despite high awareness and poor knowledge highlights the need for interventions. Factors influencing utilization include age, knowledge, and level of study. Barriers such as religion, fear of side effects, and partner consent must be addressed. Recommendations include sensitization campaigns, establishing a youth-friendly center on campus, incorporating contraception into curricula, collaborating with NGOs, and increasing funding for research.

Women's Emergency Contraception Knowledge Level, Some Related Factors And Relationship With Health Literacy

Amaç: Kadınların acil kontrasepsiyon hakkındaki bilgi düzeylerinin saptanması, ilişkili olduğu düşünülen bazı değişkenlerin incelenmesi ve sağlık okuryazarlığı ile ilişkisinin değerlendirilmesidir. Gereç ve yöntem: Bu çalışma, Haziran 2021-Ekim 2021 tarihlerinde arasında Sakarya’da bir Eğitim ve Araştırma Hastanesi’nin Kadın Hastalıkları ve Doğum Polikliniğine başvuran kadınlar üzerinde gerçekleştirilen kesitsel tipte bir araştırmadır. Çalışma grubu 456 kadından oluşmuştur. Çalışmada veriler, yüz yüze görüşme yöntemiyle elde edilmiştir. Kadınların acil kontrasepsiyon bilgi düzeyleri literatürden faydalanılarak hazırlanan 20 sorudan oluşan acil kontrasepsiyon bilgi formu ile değerlendirilmiştir. Bilgi sorularından 6.9 ve üzeri puan alanlar acil kontrasepsiyon hakkında bilgi düzeyi yeterli olarak kabul edilmiştir. Sağlık okuryazarlık düzeyinin belirlenmesi için Avrupa Sağlık Okuryazarlığı Ölçeği Kısa Formu kullanılmıştır. Verilerin analizinde Ki-kare testi, Lojistik Regresyon analizi, K-Means Kümeleme Analizi ve Spearman Korelasyon Analizi kullanılmıştır. İstatistiksel anlamlılık değeri olarak p≤0.05 kabul edilmiştir. Bulgular: Çalışma grubunu oluşturanların yaşları 18-49 arasında değişmekte olup, ortalama 34.50±8.61 yıl idi. Acil kontrasepsiyon ile ilgili olarak en çok doğru bilinen bilgi sorusu %38.4 ile “Ertesi gün hapı döllenmiş yumurtanın rahim içine yerleşmesini önler” iken en çok yanlış bilinen ise %12.5 ile “Acil kontrasepsiyon için ilişki sonrası RIA uygulaması, hiç doğum yapmamış kadınlar için uygun değildir” idi. Çalışmada kadınlardan %65.1’nin acil kontrasepsiyon ile ilgili bilgi düzeylerinin yetersiz olduğu saptanmıştır. Kadınların Sağlık Okur Yazarlık Ölçeği puan ortalamasının 35.73±6.48 olduğu belirlenmiştir. Yapılan ileri analiz sonucunda “40 ve altı yaş grubunda olmak” ile “lise ve altı öğrenim düzeyine sahip olmak” yetersiz acil kontrasepsiyon bilgi düzeyi için iki risk faktörü olarak saptanmıştır. Acil kontrasepsiyon ile ilgili bilgi sorularından alınan puanlar ile sağlık okuryazarlığı ölçeğinden alınan puanlar arasında bir ilişki saptanmamıştır (r=0.029; p=0.531). Sonuç ve öneriler: Çalışmamızda kadınların yaklaşık olarak üçte ikisinin acil kontrasepsiyon hakkındaki bilgi düzeylerinin yetersiz olduğu saptanmıştır. Kadınların acil kontrasepsiyon hakkındaki bilgi düzeyleri ile sağlık okuryazarlığı düzeyleri arasında bir ilişki saptanmamıştır. İstenmeyen gebelik ve isteyerek düşüklerin önlenmesinde acil konstraseptif yöntemlerinin bilinirliğinin artması oldukça önemlidir. Kadınların acil kontrasepsiyon hakkındaki bilgi düzeylerinin artırılabilmesi için konu hakkında sağlık otoriteleri tarafından eğitim etkinliklerinin yapılması ve bu yöntemlere ulaşımın kolaylaştırılması yararlı olabilir.

Motivators for emergency contraception: Previous pregnancy and condom rupture

ObjectivesLittle is known about the motivations to apply for emergency contraception (EC). Our first aim was to explore the motivating circumstances to use EC as fast as possible. Our second aim was to explore the contraceptive method of the population seeking EC. Study designThis present retrospective observational study between July 2021 and September 2021 is embedded in the MEEC (Motivation and Epidemiology of Emergency Contraceptive Pill) based on the study cohort of a Hungarian data bank containing follow-up data of 455 women applied for EC telemedicine consultation. Variables assessed were: age, gynecological history (pregnancies, abortions, miscarriages), data of the intercourse (elapsed time, contraceptive method), and data of the menstrual cycle, and relationship status. ResultsOf all patients, 59.3 % reported condom rupture, 29.5 % no protection, and 11.2 % other. Patients using condom applied for EC significantly sooner than those using no protection and using other protective methods. A significantly shorter elapsed time was observed in patients with a history of a previous pregnancy. No significant relationship was seen between the way of protection, previous pregnancies, and surprisingly the time of ovulation despite the obvious intention of avoiding pregnancy. ConclusionsThis is the first study to examine the potential role of epidemiologic factors as motivators for EC on the basis of a large patient cohort. Our study demonstrates the significant role of condom rupture/use and the history of previous pregnancies to be the strongest motivators for EC.

Sexual and reproductive health experiences, access to services, and sources of information among university students in Ethiopia.

Adolescence and youth are times of major growth and change that can place young people at elevated risk of poor sexual and reproductive health (SRH) outcomes, particularly when they are living away from home for the first time. Understanding the barriers that young people face when accessing SRH services and information is imperative for addressing their SRH needs; our study explored this topic among university students in Ethiopia. Specifically, we explore university students' SRH experiences, access to services, and preferred sources of information. We draw on mixed-methods research conducted in four public universities across Ethiopia in early 2020. A random sample of 822 male and female students completed a cross-sectional survey that explored SRH knowledge, attitudes, experiences, and sources of information. We also conducted 8 focus group discussions with students and 8 key informant interviews across the four universities. Survey data were analyzed using descriptive statistics and we used structural coding and inductive analysis to analyze qualitative data. The survey data demonstrated that condoms and emergency contraceptive pills were the most used contraceptive methods. Nearly 18% of female students had experienced an unwanted pregnancy, and 14% reported having had an abortion. Approximately one-third of students reported encountering gender-based violence in the past 6 months. Most students preferred receiving SRH information from mass media, and male students were more likely than female students to seek information from friends. Our qualitative findings highlight a lack of comprehensive SRH care available on university campuses, and services that are available are often of poor quality; participants described a lack of privacy, confidentiality and respect when accessing SRH care at school. University students also lack regular opportunities to learn about SRH while on campus, and their preferred sources of information varied widely. Ethiopian university students have considerable unmet demand for SRH services and often face significant barriers to accessing high-quality information and services on campus. Consistent commitment and investment by universities and the government is vital to meeting the SRH needs of young people during this potentially vulnerable time.

The co-creation and evaluation of a recovery community center bundled model to build recovery capital through the promotion of reproductive health and justice

People who can get pregnant who use drugs face disproportionate harms such as violence, exploitation and trauma and have unmet reproductive health needs as they have the greatest burden of unintended pregnancy (>75%). Recovery community centers (RCCs) provide recovery support services and are primarily staffed with people with lived experience using drugs. RCCs employ recovery coaches who are entrusted with helping participants improve their recovery capital, health, and wellbeing through person-centered strengths-based approaches. Although reproductive health and the prevention of unintended pregnancy can greatly impact all domains of recovery capital, recovery coaches generally do not have training to address this complex issue. We aimed to fill this gap by co-creating and evaluating a bundled model as an intervention tailored for RCCs (training & low-barrier resources including pregnancy tests, prenatal vitamins, and emergency contraception) to promote more equitable outcomes in reproductive health. We described the training and used mixed methods to assess pre-post knowledge, belief, and comfort with the bundled model (n = 20) and further explored perceptions of the model qualitatively to inform future iterations (n = 58). Results included significant gains in all three domains following the training, as well as favorable perceptions that the model will enhance recovery capital. Most were empowered to champion the model, asking for more information about the three resources, perinatal health, and referral information. We seek to begin to expand the theoretical construct of recovery capital by pilot testing an intervention to promote recovery through enhancing reproductive health and justice for people who use drugs (PWUD) who can get pregnant.

AKT question relating to emergency contraception

AKT question relating to emergency contraception

U.S. global health aid policy and family planning in sub-Saharan Africa.

The Trump administration reinstated and expanded the Mexico City Policy (MCP) in 2017 as the Protecting Life in Global Health Assistance (PLGHA) policy, forbidding international organizations receiving all U.S. health assistance from promoting abortion. Existing evidence suggests that abortion rates rise under the MCP, but the direct effect of U.S. funding restrictions on supply and use of family planning has received less attention. By studying PLGHA's impact on health service delivery providers and women in eight sub-Saharan African countries, we are able to fill this gap. We find that health facilities provide fewer family planning services, including emergency contraception, and that women are less likely to use contraception and more likely to have given birth recently under the policy. These findings suggest that PLGHA has important unintended consequences that are detrimental to reproductive health and the autonomous decision-making of health service providers and women.

Variables predictoras del uso de los métodos anticonceptivos en jóvenes: una revisión sistemática

ObjectiveTo analyse predictor variables of contraceptive method use in young people. DesignSystematic review. Data sourcesPubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. Study selectionAn assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. Data extractionInformation was extracted on the selected study population, contraceptive method studied and predictor variables identified. ResultsSeven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes. ConclusionFuture training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.

Adding piroxicam to levonorgestrel increased emergency contraception effectiveness.

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.

Knowledge, Attitudes, and Practice About Emergency Contraception Among Saudi Women of Childbearing Age of Eastern Region in Saudi Arabia.

Background and aim Emergency contraception (EC) refers to methods of contraception that are used within 72 hours up to 120 hours after unprotected intercourse to prevent unintended pregnancy. It can postpone ovulation, stopping fertilization. Ella®(progestin receptor modulator), plan B, birth control tablets, and the copper intrauterine device(IUD) are examples of emergency contraception. The aim of the study is to evaluate knowledge, attitudes, and practices of emergency contraception among Saudi women of childbearing age in the eastern province of Saudi Arabia. Methods It is a descriptive cross-sectional study conducted in the eastern region of Saudi Arabia. Data was collected through a pretested online questionnaire after approval from an ethical committee and women's consent to participate in the study. Women between 18 and 49 years old were included in the study. Women aged under 18 and over 49 years were excluded from the study to make the sample population more homogenous. Participants were provided a link to a questionnaire form to be completed from theirdevices (phone or laptop). Results A total of 648 childbearing Saudi women completed the survey. The majority were between 18 and 25 years old. Approximately 263 (40.6%) had no children, and 348 (53.7%) earned less than 5,000 SAR monthly. Four hundred and sixty-seven(72%) of the participants had never used emergency contraception. Four hundred and seventy-eight (73.8%) did not know the maximum acceptable time for using EC. Three hundred and fourteen (48.5%) did not know the potential risks to the baby in case of failure of emergency contraception. Two hundred and twenty-three(34%)patricians wrongly believed that there would be a potential risk to the baby if the patient got pregnant after using emergency contraception. Three hundred and eight (47.5%) participants supported the idea of the availability of emergency contraception without a prescription, and a majority believed that they would not feel shy in asking for emergency contraception. Five hundred and seventy-one (88%)participants did not visit any family planning clinic last year. A significant source of EC information was a doctor or a family planner, 206 (31.8%). A considerable barrier to EC use was fear of side effects and health risks, as reported by382 (59%) respondents. Conclusions The current study reveals that participants have positive attitudes towards emergency contraception, but use is deficient because of poor knowledge and lack of awareness. Our study urges the urgent need for awareness campaigns by health professionals to improve learning and remove wrong fears and beliefs about emergency contraception.

Availability of emergency contraception in large Brazilian municipalities: a guaranteed right?

Introduction: Emergency Contraception (EC) is available in Brazil since 1996, when it was adopted as one if the family planning strategies and, in 1998, for use in services assisting victims of sexual violence. In the country, its use is regulated by guidelines. Its access through SUS (Unified Health System), however, does not seem to occur in a standardized manner.Methods: The aim of the study was to analyze the availability and barriers to accessing emergency contraception (levonorgestrel) in Brazilian municipalities with more than 500 thousand inhabitants. The survey was carried out by a form sent to the Municipal Health Departments (SMS) managers and a search on the list of standardized medicines by the hospitals in the same municipalities.Results: The Basic Health Units were identified as the standard access places to EC. However, one of the obstacles mentioned is the need for a prescription for dispensing in almost 80% of the analyzed cities. Access in emergency situations at night and on weekends is also uncertain, since although 67% of the places stated that they dispense at the hospital level, the item was only standardized in 21% of the hospital lists.Discussion: The difficult access this drug in the public system essentially tends to harm the poorest women, who are the ones who suffer most from the consequences of an unwanted pregnancy.

Unveiling reproductive choices: Knowledge and practices of emergency contraceptive pills among the female factory workers in Sri Lanka

BackgroundIn Sri Lanka, the Emergency Contraceptive Pill (ECP) is categorized as a Schedule 2A medication, allowing it to be purchased over-the-counter without a prescription, but exclusively from licensed pharmacists. It is estimated that around 3 million ECPs are consumed by Sri Lankan women each year. This study aims to assess the knowledge and practices of Female Factory Workers (FFWs) on ECP and to unearth the association with unintended pregnancy and unsafe abortion. MethodsAfter receiving written informed consent, a structured interview schedule was administered among 585 FFWs attached to eight factories in a selected Export Processing Zone (EPZ). Data analysis was performed using SPSS software. ResultsOnly 26 % of FFWs were aware of the effective time period to take an ECP to prevent a pregnancy. Most (67 %) had the impression that a valid prescription is required to purchase ECP from the pharmacies. Around one-tenth of the FFWs (11.3 %, n = 66) had used ECP during their lifetime. Among the 65 respondents who reported having experienced unintended pregnancies, only 26.2 % (n = 17) had utilized ECPs. In contrast, among the 22 respondents who disclosed a history of abortion, only two women had ever employed ECPs. ConclusionThe study highlights the low knowledge and use of ECP among FFWs in Sri Lanka, contributing to unintended pregnancy and unsafe abortion. Results call for targeted interventions to improve knowledge and access to ECP, helping to reduce unintended pregnancy and improve reproductive health outcomes.

Efficacy of oral levonorgestrel emergency contraception with same day etonogestrel contraceptive implant: A prospective observational study

ObjectiveTo 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 designIn 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. ResultsA 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%). ConclusionsIn 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. ImplicationsClients 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 RegistrationClinicaltrials.gov NCT04678817; registered 12/16/20

Emergency contraceptive provision in the emergency department and risk analysis for delayed utilization in South Korea.

In certain nations, the emergency department (ED) has been designated as the primary center to provide emergency contraception (EC). However, analyses of ED visits for EC are limited. Moreover, ED-based research that focuses on time is limited to only a few surveys. The aims of this study were to examine the characteristics of ED visitors for EC and the interval between the coitus and arrival at the ED, and to analyze the factors associated with delays in visiting the ED. This retrospective cohort study involved patients at 2 urban tertiary academic hospitals in South Korea. All patients who presented to the ED for EC between January 2019 and December 2021 were analyzed. The median age of the participants was 26 years. The most common variables were age of 20 to 29 years (42.0%), evening visits (34.9%), weekends or public holidays (62.6%), single status (89.2%), and visits after contraceptive failure (79.1%). The mean time interval was 7.49 hours, and 77.4% of all patients visited the ED within 12 hours. Patients who received public sex education presented earlier (P < .001). ED visits after nonconsensual sexual incidents represented significantly delayed presentations (P < .001). Regression analysis revealed that both the lack of public education and the occurrence of nonconsensual coitus were associated with incident-to-ED visit intervals of >12 hours. Most patients received emergency contraceptive pill (ECP) within the recommended timeframe. In particular, nationwide school-based public sex education positively affected early ECP access. In contrast, ECP provision was delayed for patients who experienced nonconsensual coitus. Strategies for timely ECP access should account for possible concerns about stigmatization and privacy.

The Efficacy of Emergency Contraception to Prevent Pregnancy: A Systematic Review and Meta-Analysis

Objective: A systematic review and meta-analysis to determine the effectiveness of various emergency contraceptive methods to prevent pregnancy.Method: This study followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) protocol. Data search used four databases, namely Pubmed, Google Scholar, Science Direct, and Wiley. Data that met the inclusion criteria were subjected to meta-analysis to analyze the combined proportion of data using MedCalc 20.012 software, calculation of a percentage of 95% Confidence Intervals (CI) and P&lt;0.05, and heterogeneity test between studies.Results: There were 6 journals that met the criteria. Some of the contraceptives used as emergency contraception are: the copper IUD (CuIUD) with effectiveness reaching 100% in preventing pregnancy, levonorgestrel (LNG) 52-mg IUS with effectiveness reaching 99.95%, the levonorgestrel (LNG) 52-mg IUD with effectiveness reaching 99.7%, mifepristone 10 mg with effectiveness reaching 99.3%, mifepristone 5 mg with effectiveness reaching 98.8%, ulipristal acetate (UPA) 30 mg in pre-ovulatory women with effectiveness reaching 98.6%, levonorgestrel (LNG) 0.75 mg with effectiveness reaching 98.3%, yuzpe regimen with effectiveness reaching 98.2%, and ulipristal acetate (UPA) 30 mg in post-ovulatory women with effectiveness reaching 97.9%. The results of the proportion meta-analysis showed the proportion of pregnancies after the use of emergency contraceptive, which was 0.231% (95% CI 0.116–0.384) from 4,927 samples in 6 studies, and the results of the heterogeneity test between studies were found to be not meaningful (I2 = 0%). Conclusion: The emergency contraception used to prevent pregnancy is very effective with the results of a meta-analysis of the proportion of 0.231% (95% CI 0.116–0.384). This suggests that the percentage of pregnancies after emergency contraceptive use is quite low.Efektivitas Kontrasepsi Darurat untuk Mencegah Kehamilan: Tinjauan Sistematis dan Meta-AnalisisAbstrakTujuan: Tinjauan sistematis dan meta-analisis untuk mengetahui efektivitas berbagai metode kontrasepsi darurat untuk mencegah kehamilan.Metode: Penelitian ini mengikuti protokol Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Pencarian data menggunakan empat database yaitu Pubmed, Google Scholar, Science Direct, dan Wiley. Data yang memenuhi kriteria inklusi dilakukan meta analisis dengan analisis proporsi gabungan data menggunakan software MeldCalc 20.012, dilakukan perhitungan persentase 95% CI dan P&lt;0.05, serta dilakukan uji heterogenitas antar studi.Hasil: Terdapat 6 jurnal yang memenuhi kriteria. Beberapa alat kontrasepsi yang digunakan sebagai kontrasepsi darurat yaitu: AKDR tembaga (CuIUD) dengan efektivitas mencapai 100% dalam mencegah kehamilan, levonorgestrel (LNG) 52-mg IUS dengan efektivitas mencapai 99,95%, levonorgestrel (LNG) 52-mg IUD dengan efektivitas mencapai 99,7%, mifepristone 10 mg dengan efektivitas mencapai 99,3%, mifepristone 5 mg dengan efektivitas mencapai 98,8%, ulipristal asetat (UPA) 30 mg pada wanita pre-ovulasi dengan efektivitas mencapai 98,6%, levonorgestrel (LNG) 0,75 mg dengan efektivitas mencapai 98,3%, yuzpe regimen dengan efektivitas mencapai 98,2%, dan ulipristal asetat (UPA) 30 mg pada wanita post-ovulasi dengan efektivitas mencapai 97,9%. Hasil meta analisis proporsi menunjukkan proporsi kehamilan setelah penggunaan kontrasepsi darurat yaitu 0,231% (95% CI 0,116–0,384) dari 4.927 sampel, serta hasil uji heterogenitas antar studi ditemukan tidak bermakna (I2 = 0%).Kesimpulan: Penggunaan kontrasepsi darurat sangat efektif dalam mencegah kehamilan dengan hasil meta analisis proporsi yaitu 0,231% (95%CI 0,116–0,384). Hasil tersebut menunjukkan bahwa persentase kehamilan setelah penggunaan kontrasepsi darurat cukup rendah.Kata kunci: Efektivitas, Kontrasepsi Darurat

The Efficacy of Emergency Contraception to Prevent Pregnancy: A Systematic Review and Meta-Analysis

Objective: A systematic review and meta-analysis to determine the effectiveness of various emergency contraceptive methods to prevent pregnancy. Method: This study followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) protocol. Data search used four databases, namely Pubmed, Google Scholar, Science Direct, and Wiley. Data that met the inclusion criteria were subjected to meta-analysis to analyze the combined proportion of data using MedCalc 20.012 software, calculation of a percentage of 95% Confidence Intervals (CI) and P&lt;0.05, and heterogeneity test between studies. Results: There were 6 journals that met the criteria. Some of the contraceptives used as emergency contraception are: the copper IUD (CuIUD) with effectiveness reaching 100% in preventing pregnancy, levonorgestrel (LNG) 52-mg IUS with effectiveness reaching 99.95%, the levonorgestrel (LNG) 52-mg IUD with effectiveness reaching 99.7%, mifepristone 10 mg with effectiveness reaching 99.3%, mifepristone 5 mg with effectiveness reaching 98.8%, ulipristal acetate (UPA) 30 mg in pre-ovulatory women with effectiveness reaching 98.6%, levonorgestrel (LNG) 0.75 mg with effectiveness reaching 98.3%, yuzpe regimen with effectiveness reaching 98.2%, and ulipristal acetate (UPA) 30 mg in post-ovulatory women with effectiveness reaching 97.9%. The results of the proportion meta-analysis showed the proportion of pregnancies after the use of emergency contraceptive, which was 0.231% (95% CI 0.116–0.384) from 4,927 samples in 6 studies, and the results of the heterogeneity test between studies were found to be not meaningful (I2 = 0%). Conclusion: The emergency contraception used to prevent pregnancy is very effective with the results of a meta-analysis of the proportion of 0.231% (95% CI 0.116–0.384). This suggests that the percentage of pregnancies after emergency contraceptive use is quite low. Efektivitas Kontrasepsi Darurat untuk Mencegah Kehamilan: Tinjauan Sistematis dan Meta-Analisis Abstrak Tujuan: Tinjauan sistematis dan meta-analisis untuk mengetahui efektivitas berbagai metode kontrasepsi darurat untuk mencegah kehamilan. Metode: Penelitian ini mengikuti protokol Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). Pencarian data menggunakan empat database yaitu Pubmed, Google Scholar, Science Direct, dan Wiley. Data yang memenuhi kriteria inklusi dilakukan meta analisis dengan analisis proporsi gabungan data menggunakan software MeldCalc 20.012, dilakukan perhitungan persentase 95% CI dan P&lt;0.05, serta dilakukan uji heterogenitas antar studi. Hasil: Terdapat 6 jurnal yang memenuhi kriteria. Beberapa alat kontrasepsi yang digunakan sebagai kontrasepsi darurat yaitu: AKDR tembaga (CuIUD) dengan efektivitas mencapai 100% dalam mencegah kehamilan, levonorgestrel (LNG) 52-mg IUS dengan efektivitas mencapai 99,95%, levonorgestrel (LNG) 52-mg IUD dengan efektivitas mencapai 99,7%, mifepristone 10 mg dengan efektivitas mencapai 99,3%, mifepristone 5 mg dengan efektivitas mencapai 98,8%, ulipristal asetat (UPA) 30 mg pada wanita pre-ovulasi dengan efektivitas mencapai 98,6%, levonorgestrel (LNG) 0,75 mg dengan efektivitas mencapai 98,3%, yuzpe regimen dengan efektivitas mencapai 98,2%, dan ulipristal asetat (UPA) 30 mg pada wanita post-ovulasi dengan efektivitas mencapai 97,9%. Hasil meta analisis proporsi menunjukkan proporsi kehamilan setelah penggunaan kontrasepsi darurat yaitu 0,231% (95% CI 0,116–0,384) dari 4.927 sampel, serta hasil uji heterogenitas antar studi ditemukan tidak bermakna (I2 = 0%). Kesimpulan: Penggunaan kontrasepsi darurat sangat efektif dalam mencegah kehamilan dengan hasil meta analisis proporsi yaitu 0,231% (95%CI 0,116–0,384). Hasil tersebut menunjukkan bahwa persentase kehamilan setelah penggunaan kontrasepsi darurat cukup rendah. Kata kunci: Efektivitas, Kontrasepsi Darurat

Anticoncepción de emergencia en estudiantes universitarios. ¿Qué tanto usan y conocen este método los jóvenes?

Objective: To determine the level of knowledge that a group of university students have about emergency contraception, in addition to knowing how often they use these methods. Methods: Quantitative, correlational, cross-sectional research. A survey was applied to all the students of the Physiopathology course of the Pharmacy and Bioanalysis Faculty of the Universidad de Los Andes in Mérida-Venezuela. The data collection instrument was validated by Matzumura-Kasano in her research and was used with previous authorization, in addition, a review of the literature was made, inquiring about the most controversial aspects of emergency contraceptives. Results: 87 people surveyed, between 21 and 36 years old, 66 women. Seventy-seven percent actively have sexual intercourse. 59.8 % have never received information on emergency contraception methods. 71.2 % know the ideal time to use postcoital contraceptives. 89.7% consider that emergency contraceptives are not safe and have repercussions on health, 82.8% think that they are not effective in preventing pregnancy and 53% do not know how they work. Conclusion: There is little education about emergency contraceptives among the respondents, most of them do not know how they work. Most of the respondents know the ideal time to use postcoital methods, but consider that they are not safe, have health repercussions and are not effective in preventing pregnancy, which demonstrates the need to inform the population.

Post-exposure prophylaxis, STI testing and factors associated with follow-up attendance: a review of 4159 cases of acute post-sexual assault medical care

BackgroundSexual assault (SA) is a prevalent issue with enduring consequences. Post-SA medical care mainly focuses on injuries, sexually transmitted infection (STI) prevention and detection, as well as preventing unwanted pregnancies....

Do Indian women know about anduse the emergency contraceptive pill? An analysis ofnationally representative data from 2005-06 and2019-21.

The emergency contraceptive pill (ECP) is a post-coital contraceptive method that prevents unintended pregnancy and is useful in specific circumstances. This study examined the awareness and use of the ECP in India, as there is scarce evidence in this area to guide policy development. This study used data from the 2005-06 (n=124 385) and 2019-21 (n=724 115) rounds of the National Family Health Survey of India. Bivariate analysis and multivariate logistic regression were applied to explore how demographic characteristics including age, education (none, primary, secondary, higher), wealth quintile, place of residence (urban, rural), marital status, parity, desire for children, whether current pregnancy was wanted, whether the women had had an abortion in the past 5 years, and whether current use of contraceptive methods affected the likelihood of knowledge and use of ECP. In the past 15 years, knowledge of ECP has increased by 37 percentage points but still remains relatively low at 48%. Less than 1% of the sample (0.55%) used ECP. Women aged 30-34 years, from wealthier and more educated backgrounds, living in urban areas, and currently using condoms had a higher likelihood of using ECP in comparison with women from age group 15-19 years, those from the poorest backgrounds, those with no education, those living in rural areas and those not using any contraceptive method, respectively. In comparison to married women, never-married women exhibited a higher awareness of ECP but lower use. More efforts must be made to improve awareness of the ECP, especially among adolescents, those with less education, poorer women and those in rural areas. The government is taking steps to improve access to ECP, and India's female community health workers, the ASHAs, could be further supported to enhance awareness of ECP.