title: What impact has England's Teenage Pregnancy Strategy had on young people's knowledge of and access to contraceptive services?
abstract: OBJECTIVE
  To describe young people's knowledge and use of contraceptive services over initial stages of England's Teenage Pregnancy Strategy, and to investigate factors associated with use of different services.
  
  
  METHODS
  A random location sample of young people aged 13-21 years (n = 8879) was interviewed in 12 waves over 2000-2004. Individual data were analysed to investigate factors associated with knowledge and use of contraceptive services and to observe trends over time. Area-level data were analyzed to explore differences in key variables.
  
  
  RESULTS
  In all, 77% of young women and 65% of young men surveyed knew a service they could use to obtain information about sex. Amongst those who had had vaginal sexual intercourse, the most common source of contraceptive supplies was general practice for young women (54%) and commercial venues for young men (54%). Young women's use of school-based services to obtain supplies increased significantly from 15.4% in Year 1 to 24.4% in Year 4, p < .001. Young men's use of the commercial sector declined significantly over the same time period (60.3% to 50.6%, p = .002), while their use of general practice and family planning clinics increased (from 8.9% to 12.4%, p = .008, and 21.2% to 29.1%, p = .054, respectively). Use of family planning clinics and designated young people's clinics was associated with first vaginal intercourse before the 16th birthday and living in a deprived area.
  
  
  CONCLUSIONS
  Young people's patterns of contraceptive service use have changed since implementation of the Strategy; although no increase in overall service use was observed. The contribution of school-based services needs further exploration.
authors.affiliation: Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, University College London, London, United Kingdom. rfrench@gum.ucl.ac.uk
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: French
authors.forename: Catherine H
authors.initials: CH
authors.lastname: Mercer
authors.forename: Roslyn
authors.initials: R
authors.lastname: Kane
authors.forename: Patricia
authors.initials: P
authors.lastname: Kingori
authors.forename: Judith M
authors.initials: JM
authors.lastname: Stephenson
authors.forename: Paul
authors.initials: P
authors.lastname: Wilkinson
authors.forename: Chris
authors.initials: C
authors.lastname: Grundy
authors.forename: Kate
authors.initials: K
authors.lastname: Lachowycz
authors.forename: Paul
authors.initials: P
authors.lastname: Jacklin
authors.forename: Maryjane
authors.initials: M
authors.lastname: Stevens
authors.forename: Sue
authors.initials: S
authors.lastname: Brooker
authors.forename: Kaye
authors.initials: K
authors.lastname: Wellings
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003270:Contraceptive Agents / Q000600:supply & distribution; D003273:Contraceptive Devices / Q000600:supply & distribution; D004739:England; D005193:Family Planning Services / Q000592:standards / Q000706:statistics & numerical data* / Q000600:supply & distribution; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011204:Poverty Areas; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control* / Q000706:statistics & numerical data; D012572:School Health Services; D012725:Sexual Behavior
chemical_list: D003270:Contraceptive Agents