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1、PregnancyExperience & UseofEmergencyContraceptionAmongYoungWomenintheBayAreaShiraRutmanJune2006SignificanceThreeandahalfmillionunintendedpregnanciesoccureachyearintheUnitedStates.(Henshaw1998)Emergencycontraception[EC]hasthepotentialtoprevent50%ofthesepregnanciesand60-70%ofabortion
2、sannually.(Trussel1992)ECiseffectivewhentaken72to120hoursafterintercourse,butismosteffectivethesooneritistaken.(Ellertson2003)“Parent”Study Design&SettingArandomized,single-blind,controlledtrialConductedbyinvestigatorsatUCSFJuly2001toJune2003atfourCaliforniaclinicsprovidingfamilypl
3、anningservicesThreearms:advanceprovision,pharmacyaccessandclinic(control)Examinedreproductiveoutcomes(pregnancy,STIsandcontraceptive/sexualbehaviorsTotalN=2,117ParticipantsYoungwomen15-24yearsoldSpokeEnglishorSpanishHadsexualintercourseintheprevioussixmonths(“sexuallyactive”)Livedi
4、ntheSanFranciscoBayAreaAvailableforfollow-up6monthslaterParticipantscontinuedNotpregnantordesiringpregnancyNotusinglong-termhormonalcontraception(injectables,IUDorimplants)NotrequestingECattheenrollmentHadnothadunprotectedintercourseinthepreviousthreedaysNotusing“patch”or“ring”(not
5、yetFDAapproved)“Parent”StudyFindingsNosignificantreductioninpregnancyratesinpharmacyaccessandadvanceprovisiongroupsNoincreaseinSTIsNodifferencesbystudygroupin:contraceptivepatternscondomusesexualbehaviorsECuseduringthestudyN=571(26.9%)“Thepublichealthimpactmaybenegligiblebecauseofh
6、ighratesofunprotectedintercourseandrelativeunderutilizationofthemethod.”RaineTR,HarperCC,RoccaCH,FischerR,PadianN,KlausnerJD,DarneyPD.DirectaccesstoemergencycontraceptionthroughpharmaciesandeffectonunintendedpregnancyandSTIs:arandomized,controlledtrial.JAMA2005;293:54–62.StudyHypot
7、hesesYoungwomenwhohaveexperiencedpregnancyaremorelikelytouseEC,thanyoungwomenwhohavenotexperiencedpregnancy.2)Amongyoungwomenwhohaveexperiencedpregnancy,thosewhohaveexperiencedabortionaremorelikelytouseEC,thanyoungwomenwhohavenotexperiencedabortion,whomayormaynothaveexperiencedpreg
8、nancy.MeasuresOutcomeMeasu
