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Advance provision of emergency contraceptive pills reduces treatment delay: a randomized controlled trial among Swedish teenage girls
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Internationell kvinno- & mödrahälsovård/Essén))
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Internationell kvinno- & mödrahälsovård/Essén))
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa. (Internationell kvinno- & mödrahälsovård/Essén))
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
2008 (Engelska)Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 87, nr 3, s. 354-359Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To evaluate an intervention involving advance provision of emergency contraceptive pills (ECP) to Swedish teenage girls. MATERIAL AND METHODS: Some 420 girls aged 15-19, requesting ECP at a local youth clinic were randomly assigned to intervention group (IG) (n=214) or control group (CG) (n=206). Both groups received ECP on request. The IG received one extra dose of ECP, condoms and an information leaflet regarding ECP and condom use. Main outcome measures were differences between IG and CG regarding ECP use, time span between unprotected intercourse and ECP intake, contraceptive use, and sexual risk taking. Questionnaires were completed at the initial visit, and the girls were followed up by structured telephone interviews 3 and 6 months later. RESULTS: At the 3-month follow-up, girls in the IG were almost twice as likely to have used ECP compared to girls in the CG (IG: 24.0%, CG: 13%, p=0.02), and they used it sooner after unprotected intercourse (mean time IG: 13.61 h, CG: 25.47 h, p=0.007). Significant differences persisted 6 months after the intervention (ECP use IG: 31%, CG: 19%, p=0.01; and mean time IG: 15.59 h, CG: 26.38 h, p=0.006). No significant differences were found in the use of regular hormonal contraceptives or condoms at either follow-up. About 40% of the girls in both groups had risked pregnancy during the follow-up period, but only half of these had used ECP. CONCLUSIONS: This intervention shortened the time interval from unprotected intercourse to pill intake without jeopardising contraceptive use and without increasing sexual risk taking.

Ort, förlag, år, upplaga, sidor
2008. Vol. 87, nr 3, s. 354-359
Nyckelord [en]
Emergency contraception, teenage girls, RCT, Sweden
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:uu:diva-96963DOI: 10.1080/00016340801936024ISI: 000253644400015PubMedID: 18307077OAI: oai:DiVA.org:uu-96963DiVA, id: diva2:171712
Tillgänglig från: 2008-04-03 Skapad: 2008-04-03 Senast uppdaterad: 2017-12-14Bibliografiskt granskad
Ingår i avhandling
1. Sexual Risk Taking: – Perceptions of Contraceptive Use, Abortion, and Sexually Transmitted Infections Among Adolescents in Sweden
Öppna denna publikation i ny flik eller fönster >>Sexual Risk Taking: – Perceptions of Contraceptive Use, Abortion, and Sexually Transmitted Infections Among Adolescents in Sweden
2008 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Alternativ titel[sv]
Sexuellt risktagande : – svenska ungdomars inställning till, och erfarenhet av preventivmedel, abort och sexuellt överförbara infektioner
Abstract [en]

The overall aim of this thesis was to inestigate Swedish adolescents' perceptions and behaviours regarding sexual risk taking. Specific objectives were to explore teenagers' perceptions of contraceptive use, unintended pregnancy, and abortion; teenage girls' experiences of decision making process and support connected to abortion; and male adolescents' perceptions of sexual risk taking and barriers to practicing safe sex. Another objective was to evaluate the effect of advance provision of emergency contraceptive pills to teenage girls. The methodologies included focus group discussions, in-depth interviews, and a randomized controlled trial.

Among the adolescents in our studies, teenage parenthood was generally viewed as a "catastrophe", and the majority expressed supportive attitudes towards abortion (studies I-IV). Occasions of failure to use contraceptives were common, especially when sex was unplanned (studies I-V). Pregnancy prevention was perceived as the woman's responsibility. However, many girls were reluctant about using homonal contraceptives due to worries about negative side effects (I, III). Initiating condom use was difficult for girls, as well as for boys, for a number of reasons (I-IV): fear of ruining an intimate situation, associations with disease, distrust, pleasure reduction, and (for the boys) the fear of loosing one's erection. Males generally perceived personal and partner-related risks connected to unprotected intercourse as low. Few males were worried that an unintended pregnancy would be carried to term, and the majority would urge the girl towards abortion if she seemed ambivalent (II, IV). Girls viewed the abortion decision as a natural, yet difficult choice, strongly influenced by attitudes of partners, parents, peers and societal norms (III). Teenage girls provided with emergency contraceptive pills in advance used it more frequently and sooner after unprotected intercourse compared with controls, without jeopardising regular contraceptive use (V).

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2008. s. 81
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 325
Nyckelord
Obstetrics and gynaecology, Adolescents, attitudes, sexual risk taking, contraceptive use, unintended pregnancy, teenage abortion, communication, gender, decision making, STI, Chlamydia, condom use, Health Belief Model, emergency contraception, RCT, Obstetrik och kvinnosjukdomar
Identifikatorer
urn:nbn:se:uu:diva-8598 (URN)978-91-554-7144-6 (ISBN)
Disputation
2008-04-25, X, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15
Opponent
Handledare
Tillgänglig från: 2008-04-03 Skapad: 2008-04-03Bibliografiskt granskad

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