Use Of Emergency Contraception Research Articles

The influence of motives on alcohol- and sex-related behaviors among female college students

PurposeAlthough previous studies have elucidated associations between motivations for drinking and sex as they relate to risky health outcomes among female college students, the utility of cross-domain motives (i.e., alcohol motives predicting sex-related outcomes and vice versa) in the prediction of specific alcohol- and sex-related behaviors has yet to be examined. The current study examined relations between drinking and sex motives with multiple risky alcohol- and sex-related outcomes (i.e., alcohol consumption, alcohol-related problems, alcohol consumption prior to sexual intercourse, number of sexual partners [vaginal, oral, anal], and emergency contraception use). ProceduresMultiple structural equation models were used to examine univariate and multivariate associations among drinking and sex motives and specific outcomes in a sample of female undergraduates with lifetime histories of alcohol use and sexual activity (N = 436; 77% White, 21% Hispanic). ResultsFindings indicated differential associations between motives and specific outcomes across univariate versus multivariate analyses. Multivariate models indicated greater endorsement of enhancement and less endorsement of intimacy sex motives were significantly associated with heavy drinking and alcohol-related problems, whereas alcohol motives were less reliably linked to sex-related outcomes. When considered simultaneously, sex motives accounted for more variance in some alcohol outcomes relative to certain drinking motives. ConclusionsCross-domain motives may be useful in predicting risky outcomes among female college students. Research implications include the importance of examining motive-behavior relations in univariate and multivariate contexts. Clinical implications include cross-domain motive assessment and use of emotion regulation strategies to reduce emotionally-motivated maladaptive alcohol- and sex-related behaviors.

KNOWLEDGE, ATTITUDE AND PRACTICE OF EMERGENCY CONTRACEPTIVES AMONG FEMALE UNIVERSITY STUDENTS IN ETHIOPIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

ABSTRACT BACKGROUND: Unwanted pregnancy followed by unsafe abortion is one of the major worldwide health problems, which has many negative consequences on the health and well-being of women. Emergency contraception is a type of modern contraception that is indicated after unprotected sexual intercourse when regular contraception is not in use. This study summarized the knowledge, attitude and practice of ECs among female university students in Ethiopia. METHODS: A systematic review and meta-analysis of observational studies were conducted. Original studies were identified using databases of PubMed, Medline, Embase, Cinahl and Web of science. Heterogeneity across studies was checked using Cochrane Q test statistic and I2 test. The pooled prevalence of the knowledge, attitude and practice of ECs methods were computed using a random effect model. RESULTS: A total of 321 articles were retrieved through the initial search strategy, producing 15 observational studies from universities of Ethiopia for analysis. Based on the studies included in the meta-analysis, the pooled prevalence of level of knowledge, attitude and magnitude of utilization of ECs were 57.7% (95% CI: 49.8 to 65.3), 42.6% (95% CI: 41.4 to 43.8) and 9.2% 95% CI: 6.6 to 12.6), respectively. On the other hand, significant heterogeneity was observed between studies (Q = 664.9, p = 0.000, I2 = 97.9%). CONCLUSION: This meta-analysis revealed that the pooled prevalence of level of knowledge, attitude and the magnitude of utilization of ECs were relatively low among female university students in Ethiopia. Hence, behavioral change strategies should be considered by responsible bodies to improve knowledge and bring attitudinal change on use of emergency contraception. KEYWORDS: Emergency contraceptives, Knowledge, Attitude, Practice, Meta-analysis, Systematic review, Ethiopia. (Ethiopian Journal of Reproductive Health 2017;9:60-71)

Prevalence of and Factors Associated with Emergency Contraceptive Use among Female Undergraduates in Arba Minch University, Southern Ethiopia, 2015: A Cross-Sectional Study

Emergency contraceptives (ECs) need to be available and used appropriately as a backup in case regular contraception is not taken by people like university students. This study was conducted to assess emergency contraception use and its associated factors among female undergraduates of Arba Minch University. A cross-sectional study was conducted among 515 undergraduates using a structured questionnaire. Respondents were selected by the stratified random sampling technique and data were analyzed using SPSS version 20. Bivariate and multivariate logistic regression models were fitted to identify associated factors. The adjusted odds ratio with a 95% confidence interval was used to present the identified risk factors. The prevalence of emergency contraception use among Arba Minch University students was 78.0% (95% CI: 71.5%, 84.5%). Better information about emergency contraceptives (AOR = 6.3; 95% CI: 2.4, 9.7), good approach of EC service providers (AOR = 9.3; 95% CI: 2.4, 11.6), and positive attitude about ECs (AOR = 2.4; 95% CI: 1.5, 7.2) were factors significantly associated with EC use. The prevalence of emergency contraceptive use noted in this study was comparatively higher than the results found by previous studies conducted in Africa and Ethiopian universities. Continuing support for and wider dissemination of the class are recommended. The fact that the students/participants readily accepted the preceding provisions made such positive findings possible and sustainable.

Levonorgestrel only emergency contraceptive use and risk of ectopic pregnancy in Eldoret Kenya: a case-control study.

Introductionectopic pregnancy is one of the causes of maternal morbidity and mortality in sub-Saharan Africa. Levonorgestrel (LNG) only emergency contraceptive pill is a well-established emergency contraceptive pill that is administered within 72 hours after unprotected intercourse. This study aimed at determining whether or not there is a significant association between levonorgestrel emergency contraceptive use and the occurrence of ectopic pregnancy.Methodscase-control (1:3) study among 79 women with ectopic pregnancy (cases) matched against 237 women without (controls) at Moi Teaching and Referral Hospital in Eldoret, Kenya; Sociodemographic and clinical data were collected using a questionnaire. Association between ectopic pregnancy and LNG-EC was assessed using Pearson chi-square test. The relationship between outcome and exposure (while adjusting for confounders) was assessed using logistic regression model.ResultsThe mean age was 27.15 years. Both cases and controls were similar by age (p = 0.990), educational level (p = 0.850), marital status (p = 0.559), employment status (p = 0.186) and parity (p = 0.999). Seventy-eight (24.7%) participants had a history of miscarriage. A higher proportion of the cases had history of using LNG-EC compared to the controls (32.9% vs. 7.2%, p < 0.001). The use of LNG-EC portended more than nine times increased odds of ectopic pregnancy compared to other contraceptive methods {OR = 9.34 (95% CI: 3.9 - 16.0)}.Conclusionlevonorgestrel only emergency contraceptive use was associated with ectopic pregnancy. One of the limitations of this study is that we could not control for all confounders of ectopic pregnancy.

Update on the use of emergency contraception

In March 2017, the Faculty of Sexual and Reproductive Healthcare (FSRH) issued a new guideline on emergency contraception. This article provides an overview of the current approach to managing emergency contraception to help busy clinicians tailor the most appropriate method to each individual.

Medical advancements: emergency contraception (EC). Medico-legal implications of EC on adolescents.

The article's main focus is documenting what the best options are in order to make sure that minors are allowed to play a key role in the management of issues arising from the use of emergency contraception. In that regard, there is a lack of clean-cut legislative measures and, although there are several legal and ethical norms designed to get parents or legal guardians involved in such decisions, there seems to be an increasingly widespread tendency to give weight to the minor's will, thus acknowledging her decision-making capacity. Lastly, the paper's authors undertake a thorough examination as to what the duties of doctors are, and the measures that need to be put in place in order to safeguard the minor patients' conditions. They arrive at the conclusion that emergency contraception is suitable for minors even in absence of the stated consent from their parents or guardians, but it is of utmost importance to implement adequate measures aimed at the provision of proper care, prevention and education.

Fertility behaviour and contraceptive use in urban slums of district Gorakhpur

Background: Number of slums in India has increased significantly over the last decade (2001-11). Slums lack basic amenities and health care facilities. Very little is known about reproductive behaviour and use of family planning methods in slums. The objective of the study was to study the fertility behaviour and contraceptive use among eligible couples residing in slums of Gorakhpur district.Methods: A cross sectional study was carried out between September 2013- August 2014 among 215 eligible couples in slums of Gorakhpur district using a semi-structured questionnaire.Results: Mean age of marriage was 18.2 years, consummation of marriage was 18.9 year and 1st conception was 19.7 year. In age group 20-24 years, about 42% females had at least 2 children. About half of the females in the age group 25-29 years had 3 or more than 3 children. More than three fourth of eligible couples in age group 30- 34 and 35- 39 years had three or more than three children ever born. High sex preference was observed for male child. Couples with sex preference had bigger families. OCP and IUCD were commonly used in couples with age of wife less than 25 year. Use of condom was maximum in women &gt;35 year. Use of emergency contraceptive was maximum in females in the age group 25-35 year. Use of DMPA and permanent sterilisation (Tubectomy) was higher in couples with age of female &gt;25 year. None of the couples reported vasectomy.Conclusions: Family planning needs of young eligible couples in slums needs to be addressed. Early marriage of females and Sex preference is a common practice in slums and needs consistent Social Behaviour Change Communication.

Prevalence and Correlates of Emergency Contraceptive Use in Transitional Albania.

The two emergency contraceptive drugs ("morning-after pill") ulipristal acetate and levonorgestrel are available without prescription in many European countries. In Albania, ulipristal acetate is not marketed yet and levonorgestrel has still prescription-only status. The objective of this study was to assess the prevalence and socioeconomic correlates of emergency contraceptive (EMC) use, collect sales figures, and gain information on the women's way of purchasing EMCs in post-communist Albania. For this cross-sectional study, self-administered questionnaires were made accessible to women in Albania in March 2015 by hard copy or online via social networks. Women were asked about lifetime use and last year's use of EMCs, and if they purchased EMCs with or without a prescription. Additionally, pharmacies were contacted and asked about EMC sales figures. Of the 205 participating women, 80.5% knew about the availability and use of EMCs, and 15.1% reported EMC use during the previous 12 months. The lifetime prevalence of use was 46.8%. Although having prescription-only status in Albania, 96% of the women bought EMCs without a physician's prescription. Knowledge was significantly lower among the lower educated women and among women residing in small cities. Use of EMCs was significantly higher in women with a weaker financial background and, compared with small cities, in those from large or mid-sized cities. The 54 participating pharmacies (3% of all Albanian pharmacies) reported selling 11 EMCs on average per month. The use of EMCs may be estimated at 0.22 defined daily doses per 1,000 inhabitants per day. Compared to January 2015, EMC sales increased by 17% in February 2016. Compared to other European countries, the prevalence of EMC use seems to be higher in Albania. Use and knowledge of EMCs depend on socioeconomic characteristics. It is recommended to switch EMCs to non-prescription status in transitional Albania.

Assessment of male involvement in emergency contraception in the University of Benin, Benin City, Edo State

Background : Emergency contraception (EC) refers to the use of drugs or a device as an emergency measure to prevent pregnancy. Lack of awareness and appropriate use of emergency contraception after unprotected sexual intercourse can lead to unwanted pregnancies and unsafe abortions. Male involvement in contraceptive practices could help reduce these sequelae. This study assessed the knowledge, attitude and practice of emergency contraception and extent of partners’ communication with each other on pregnancy prevention among male students in the University of Benin, Benin City. Methods : A descriptive cross-sectional study was carried out on 400 male students of the University of Benin selected by multistage sampling technique. Data was obtained with pretested interviewer administered questionnaire. Data was analyzed with SPSS version 20 and statistical significance was determined using Chi square and Fishers exact with p value set at < 0.05. Results : Three hundred and thirty-four (95.4%) of the respondents, had incorrect knowledge of Emergency Contraception (EC) while 293 (83.7%) respondents had a good attitude toward EC. One hundred and seventy-five (80.3%) of the respondents’ partners have used emergency contraception and only 93 (43.1%) respondents discussed pregnancy prevention with their partners. Conclusion : The knowledge of emergency contraception among respondents was poor. However, most respondents had positive attitude towards its use and majority of their partners had used EC. Therefore, health education program on pregnancy prevention methods is recommended to improve respondents’ knowledge. Keywords : Emergency contraception, Male involvement, Knowledge, Attitude, Pregnancy prevention

Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2017.

To improve women's quality of life, the activity of the Women's Health Care Committee over a year up to July 2017 focused upon: (i) breast management; (ii) the influence of gynecological disease therapy on physical condition; (iii) non-surgical management of pelvic organ prolapse; (iv) survey of infectious diseases in obstetrics and gynecology in Japan; (v) health care for female athletes; (vi) a training program for women's health care advisors; (vii) revising the Japanese guidelines on hormone replacement therapy; and (viii) revising the 2016 Japanese guidelines for the proper use of emergency contraceptives. The detailed activity of the eight subcommittees is described herein. This report is based on the Japanese version of our annual report (Acta Obst Gynaec Jpn 2017;69(6):1480-1491), to publicize the activities of our committee.

Ethnic variations in sexual behaviours and sexual health markers: findings from the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

SummaryBackgroundSexual health entails the absence of disease and the ability to lead a pleasurable and safe sex life. In Britain, ethnic inequalities in diagnoses of sexually transmitted infections (STI) persist; however, the reasons for these inequalities, and ethnic variations in other markers of sexual health, remain poorly understood. We investigated ethnic differences in hypothesised explanatory factors such as socioeconomic factors, substance use, depression, and sexual behaviours, and whether they explained ethnic variations in sexual health markers (reported STI diagnoses, attendance at sexual health clinics, use of emergency contraception, and sexual function).MethodsWe analysed probability survey data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3; n=15 162, conducted in 2010–12). Reflecting Britain's current ethnic composition, we included in our analysis participants who identified in 2011 as belonging to one of the following seven largest ethnic groups: white British, black Caribbean, black African, Indian, Pakistani, white other, and mixed ethnicity. We calculated age-standardised estimates and age-adjusted odds ratios for all explanatory factors and sexual health markers for all these ethnic groups with white British as the reference category. We used multivariable regression to examine the extent to which adjusting for explanatory factors explained ethnic variations in sexual health markers.FindingsWe included 14 563 (96·0%) of the 15 162 participants surveyed in Natsal-3. Greater proportions of black Caribbean, black African, and Pakistani people lived in deprived areas than those of other ethnic groups (36·9–55·3% vs 16·4–29·4%). Recreational drug use was highest among white other and mixed ethnicity groups (25·6–27·7% in men and 10·3–12·9% in women in the white other and mixed ethnicity groups vs 4·1–15·6% in men and 1·0–11·2% in women of other ethnicities). Compared with white British men, the proportions of black Caribbean and black African men reporting being sexually competent at sexual debut were lower (32·9% for black Caribbean and 21·9% for black African vs 47·4% for white British) and the number of partners in the past 5 years was greater (median 2 [IQR 1–4] for black Caribbean and 2 [1–5] for black African vs 1 [1–2] for white British), and although black Caribbean and black African men reported greater proportions of concurrent partnerships (26·5% for black Caribbean and 38·9% for black African vs 14·8% for white British), these differences were not significant after adjusting for age. Compared with white British women, the proportions of black African and mixed ethnicity women reporting being sexually competent were lower (18·0% for black African and 35·3% for mixed ethnicity vs 47·9% for white British), and mixed ethnicity women reported larger numbers of partners in the past 5 years (median 1 [IQR 1–4] vs 1 [1–2]) and greater concurrency (14·3% vs 8·0%). Reporting STI diagnoses was higher in black Caribbean men (8·7%) and mixed ethnicity women (6·7%) than white British participants (3·6% in men and 3·2% in women). Use of emergency contraception was most commonly reported among black Caribbean women (30·7%). Low sexual function was most common among women of white other ethnicity (30·1%). Adjustment for explanatory factors only partly explained inequalities among some ethnic groups relative to white British ethnicity but did not eliminate ethnic differences in these markers.InterpretationEthnic inequalities in sexual health markers exist, and they were not fully explained by differences in their broader determinants. Holistic interventions addressing modifiable risk factors and targeting ethnic groups at risk of poor sexual health are needed.FundingMedical Research Council, the Wellcome Trust, the Economic and Social Research Council, UK Department of Health, and The National Institute for Health Research.

Non-white race is associated with increased rates of emergency contraception use in young adult cancer survivors

Non-white race is associated with increased rates of emergency contraception use in young adult cancer survivors

Awareness and Utilization of Emergency Contraceptives Among Second Cycle Primary School Female Evening Students in Hawassa, Ethiopia: A Cross-Sectional Survey

An unintended pregnancy is mistimed or unwanted one. It is significant among adolescents in Ethiopia. Sexual violence is another major health problem because of consequences such as abortion, sexually transmitted diseases and physical and mental trauma, all of which could contribute to the high rate of female drop out from schools. Use of emergency contraception (EC) reduces unintended pregnancies resulted from unprotected sexual intercourse or sexual violence and thus the risks related to it. Disparities in knowledge, access and use of family planning methods have also been observed in the country. This study assessed awareness and utilization of emergency contraceptive among 463 second cycle primary school female evening students (with age ≥ 15 years) in Hawassa using a self-administered questionnaire. Study participants were selected using stratified random sampling technique. To complement the quantitative data, key informant interviews were also held. Quantitative data was entered and analyzed using SPSS version 20. Thematic analysis was used for qualitative data. Among the total participants, 120 (25.9%) of them ever had sexual intercourse; of these only 34 (28.3%) have ever heard about EC. Majority 73 (60.8%) of those who ever had sexual intercourse expressed favorable attitude towards EC. However, only 27 (22.5%) had ever used EC. Having prior information on family planning (FP) and school grade level were identified to be positively associated [(AOR = 1.9 (1.0 - 3.4), (AOR = 2.1 (1.1 - 4.1)] with awareness about EC. Utilization of EC was found to be positively associated with knowledge about EC, AOR = 89.3 (10.8 - 737.3). Awareness and utilization of EC among primary second cycle female evening students was found to be low. In addition, exposure to FP information, grade level, marital status, knowledge about EC, and prior sexual intercourse experience were identified to be determinants of awareness and utilization of EC. Therefore awareness creation among this target group should be the priority areas of action.Keywords: emergency contraceptive, knowledge and practice, second cycle primary school evening students, Hawassa, Ethiopia

Committee Opinion No 707: Access to Emergency Contraception.

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Committee Opinion No. 707 Summary: Access to Emergency Contraception.

Emergency contraception refers to contraceptive methods used to prevent pregnancy in the first few days after unprotected intercourse, sexual assault, or contraceptive failure. Although the U.S. Food and Drug Administration approved the first dedicated product for emergency contraception in 1998, numerous barriers to emergency contraception remain. The purpose of this Committee Opinion is to examine barriers to the use of emergency contraception, emphasize the importance of increasing access, and review new methods of emergency contraception and limitations in efficacy in special populations.

Unplanned pregnancy-risks and use of emergency contraception: a survey of two Nigerian Universities

BackgroundThe vulnerabilities of young women of low socio-economic status and those with little or no formal education tend to dominate the discourse on unplanned pregnancy, unsafe abortion and emergency contraception (EC) in sub-Saharan Africa. This article draws on a survey conducted among female undergraduate students to shed light on sexual behaviour and the dynamics of emergency contraceptive use among this cohort.MethodsThe survey involved 420 female undergraduate students drawn using a multistage sampling technique, while a self-administered questionnaire was used for data collection. Univariate and bivariate analyses were applied to examine the factors associated with the use of emergency contraception.ResultsOf the 176 female students who reported being sexually active in the year preceding the survey, only 38.6% reported the use of condom during the entire year. Of those who reported unplanned pregnancy anxiety n = 94, about 30.1% used EC, 20.4% used non-EC pills as EC, while others reported having used no EC. A few respondents (n = 3) had terminated a pregnancy under unsafe conditions. Awareness of EC (p < 0.001), knowledge of timing of EC (p = 0.001), perceived risk of unplanned pregnancy (p < 0.001), and level of study (p = 0.013), were significantly correlated with the use of EC.ConclusionThe study revealed that educated youths engaged in high-risk sexual activities and also, sought recourse to unproven and unsafe contraceptive methods. Poor knowledge of EC methods and timing of use, as well as wrong perception about EC side effects, are barriers to the utilisation of EC for the prevention of unplanned pregnancy among the study participants.

P042 Emergency, implantable & intrauterine contraception use among under 18s in an integrated sexual health service

IntroductionTeenage pregnancy can be reduced by timely access to emergency contraception (EC), implants, intrauterine (IU) devices and systems and quick-starting. Routine practice is to offer <18s all contraceptive methods, emergency...

Contraceptive non-use and emergency contraceptive use at first sexual intercourse among nearly 12 000 Scandinavian women.

The aim of this study was to describe recent patterns of contraceptive use at first sexual intercourse and to examine whether selected factors are associated with non-use and emergency contraceptive pill use at first sexual intercourse, among 18- to 26-year-old women from Denmark, Norway and Sweden. This was a population-based, questionnaire study of randomly chosen 18- to 26-year-old Scandinavian women. The prevalence of contraception methods used at first sexual intercourse was calculated. Factors associated with contraceptive non-use and emergency contraceptive pill use at first sexual intercourse were determined using log binomial models. The prevalence of contraceptive non-use and emergency contraceptive pill use was lowest in Denmark (9.6 and 2.1%, respectively) compared with Norway (14.1 and 4.4%) and Sweden (16.6 and 4.5%). The risk of contraceptive non-use increased in women who had first sexual intercourse at or before 14 years of age (13-14 years: prevalence ratio 1.40; 95% confidence interval 1.24-1.58). The risk of both non-use and emergency contraceptive pill use increased when the partner at first sexual intercourse was 20 years or older, and with increasing age difference between the partner and the woman at her first sexual intercourse. Smoking initiation prior to first sexual intercourse increased risk of contraceptive non-use (prevalence ratio 1.70; 95% confidence interval 1.50-1.92), and alcohol initiation prior to first sexual intercourse increased risk of emergency contraceptive pill use at first sexual intercourse (prevalence ratio 1.95; 95% confidence interval 1.49-2.54). Contraceptive non-use at first sexual intercourse was strongly associated with early age at first sexual intercourse. Emergency contraceptive pill and contraceptive non-use at first sexual intercourse were both strongly associated with increasing partner age and an increasing difference in age between the woman and her partner. Hence, young women should be educated to negotiate contraceptive use with their partners.

High abortion rate in Martinique (F.W.I.) in spite of a large contraceptive availability. What are the determinants?

IntroductionDespite a similar health insurance coverage and access to contraception, Martinique F.W.I. has a higher rate of abortion than continental France (25.6 versus 15.3 per thousand respectively). The reasons are still largely unknown. A different contraceptive pattern, a lower use of emergency contraception in Martinique may be involved. We sought to explore the contraceptive pattern, to evaluate the use of emergency contraception and the reasons leading to an unwanted pregnancy among women seeking for an abortion. Material and methodsAn anonymous cross-sectional survey about the contraceptive use in the year and in the month before abortion, the use of emergency contraception and the reasons why, to patients’ point of view, they became pregnant albeit not willing it was proposed to women seeking for an abortion in the dedicated unit of the university hospital of Martinique. ResultsSix hundred patients were included. A total of 83.7% of patients declared having a regular contraceptive use during the year preceding. Just before abortion, 61.1% of women had no contraception or a low reliable method (fertility awareness, withdrawal…). Lack of recognition of pregnancy risk was the main reason leading to abortion, accounting for 51.1% of cases, explaining a low use of emergency contraception (13.8%), whereas a difficult access to contraception was rarely quoted. Emergency contraception was used in 27.8% of relevant situations. ConclusionInsufficient estimation of pregnancy risk is the main reason leading to unwanted pregnancy. Availability of emergency contraception does not reduce the risk.

Knowledge, Attitudes and Use of Emergency Contraceptives among Female Students of the University of Nigeria, Nsukka

Knowledge, Attitudes and Use of Emergency Contraceptives among Female Students of the University of Nigeria, Nsukka