The effect of increased access to emergency contraception among young adolescents.
OBJECTIVE
The United States Food and Drug Administration cited an absence of data on young adolescents as the reason the emergency contraceptive, Plan B, could not be moved over-the-counter. This study analyzed data on young adolescents with increased access to emergency contraception.


METHODS
We conducted an age-stratified analysis with previously published data from a randomized, controlled trial of Plan B with a sample size of 2,117, including 964 adolescents, 90 of whom were aged younger than 16 years. Participants were randomly assigned to nonprescription pharmacy access, advance provision of 3 packs, or clinic access (control). We measured contraceptive and sexual risk behaviors at baseline and 6-month follow-up and tested for pregnancy and sexually transmitted infections. We used contingency table and logistic regression analysis to measure the effect of the intervention on risk behaviors in young adolescents (< 16 years), compared with middle adolescents (16-17 years), older adolescents (18-19 years), and adults (20-24 years).


RESULTS
Adolescents aged younger than 16 years behaved no differently in response to increased access to emergency contraception (EC) from the other age groups. As with adults, EC use was greater among adolescents in advance provision than in clinic access (44% compared with 29%; P < or = .001), and other behaviors were unchanged by study arm, including unprotected intercourse, condom use, sexually transmitted infection acquisition, or pregnancy. Additionally, adolescents with increased access to EC did not become more vulnerable to unwanted sexual activity.


CONCLUSIONS
Young adolescents with improved access to EC used the method more frequently when needed, but did not compromise their use of routine contraception nor increase their sexual risk behavior.


METHODS
I.
Harper
Cynthia C
CC
Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA. harperc@obgyn.ucsf.edu
Cheong
Monica
M
Rocca
Corinne H
CH
Darney
Philip D
PD
Raine
Tina R
TR
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D044363:Contraception, Postcoital / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D012309:Risk-Taking; D012495:San Francisco; D012725:Sexual Behavior