 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Cynthia C. Harper, PhD, Center for Reproductive Health Research and Policy, University of California San Francisco, Box 0744, 3333 California Street, Ste. 335, San Francisco, CA 94143-0744, (415)502-4092, harperc@obgyn.ucsf.edu, Tina Raine, MD, MPH, Department of OB/GYN, University of California, San Francisco, 1001 Potrero Avenue, Ward 6D, San Francisco General Hospital, San Francisco, CA 94110, Corinne Rocca, MPH, Center for Reproductive Health Research and Policy, University of California, San Francisco, 3333 California Street, Suite 335, Box 0744, San Francisco, CA 94143-0744, Jeffrey D. Klausner, MD, MPH, STD Prevention and Control Services, San Francisco Dept. of Health, 1360 Mission Street, Suite 401, San Francisco, CA 94103, Phillip Darney, MD, MSc, Center for Reproductive Health Research and Policy, University of California at San Francisco, 3333 California Street, Suite 335, San Francisco, CA 93118, and Nancy S. Padian, PhD, ARI, Dept OB/GYN, UCSF, Box 0886, 74 New Montgomery, Suite 600, San Francisco, CA 94105.
Emergency contraception has become increasingly available in the United States, due to sustained public health efforts to improve service delivery. These efforts, however successful, continually face challenges from groups reluctant to increase access. In surveys, both providers and the public have expressed their concerns about sexual risk-taking and STDs. Although some self-reported data suggest that access to emergency contraception may have little effect on sexual risk-taking, this randomized, controlled trial is the first to use biological markers to measure the impact on STDs. From July 2001 to October 2002, we randomized 2,117 females (aged 15-24) to one of three distribution methods of emergency contraception: advance provision, non-prescription pharmacy access, standard clinic access. We measured the behavioral impact of these different service delivery methods on sexual risk-taking, condom use, and STD incidence. We tested participants at baseline and 6-month follow-up for Chlamydia and HSV-2, both common STDs in this age group. At baseline, 56% of participants reported using a condom at last sex, and 46% reported unprotected intercourse in the previous 6 months. One-fifth (21%) reported a history of STDs; 8% tested positive for HSV-2 and 4% for Chlamydia. Using survival analysis, we will estimate the hazard of STD incidence in each arm. We will also estimate the likelihood of unprotected intercourse and condom use by study arm, and compare the estimates of these self-reported behaviors with the STD results. Study results will be an important resource for many states debating legislation on access to emergency contraception.
Learning Objectives:
Keywords: Behavioral Research, Contraceptives
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.