title: Use of emergency contraceptive pill by 15-year-old girls: results from the international Health Behaviour in School-aged Children (HBSC) study.
abstract: OBJECTIVE
  To describe emergency contraceptive pill (ECP) use and variation across countries/regions; and to explore personal and contextual factors associated with ECP use and differences across countries/regions.
  
  
  METHODS
  Data were obtained from 11 countries/regions in the 2006 Health Behaviour in School-aged Children cross-sectional study. SETTING Data were collected by self-report questionnaire in school classrooms.
  
  
  METHODS
  The analysis is based on 2118 sexually active 15-year-old girls.
  
  
  METHODS
  Contraceptive behaviours were compared across countries/regions by chi-square tests. Individual factors related to ECP use were investigated with separate logistic regression models. Multilevel random-intercept models allowed the investigation of individual and contextual effects, by partitioning the variance into student, school and country/region levels.
  
  
  METHODS
  ECP use at last sexual intercourse.
  
  
  RESULTS
  ECP use rate varied significantly across countries/regions. Poor communication with at least one adult (odds ratio [OR] 1.62 [1.12-2.36], P = 0.011) and daily smoking (OR 1.46 [1.00-2.11], P = 0.048) were independently associated with ECP use in comparison with condom and/or birth-control pill use. Sexual initiation at 14 years or later (OR 2.02 [1.04-3.93], P = 0.039), good perceived academic achievement (OR 1.69 [1.04-2.75], P = 0.035) and daily smoking (OR 1.63 [1.01-2.64], P = 0.045) were associated with higher levels of ECP use in comparison with unprotected girls. The country-level variance remained significant in both comparisons.
  
  
  CONCLUSIONS
  These data document the large heterogeneity in rates of ECP use between countries/regions. These differences could not be explained by individual or contextual factors, and raise further questions in relation to ECP access for adolescents and their education in its appropriate use.
authors.affiliation: UMR Inserm U558, University Paul Sabatier, Toulouse, France.
authors.forename: A
authors.initials: A
authors.lastname: Gaudineau
authors.forename: V
authors.initials: V
authors.lastname: Ehlinger
authors.forename: S Nic
authors.initials: SN
authors.lastname: Gabhainn
authors.forename: C
authors.initials: C
authors.lastname: Vayssiere
authors.forename: C
authors.initials: C
authors.lastname: Arnaud
authors.forename: E
authors.initials: E
authors.lastname: Godeau
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D003075:Coitus / Q000523:psychology; D017280:Condoms / Q000706:statistics & numerical data; D003268:Contraception Behavior; D003281:Contraceptives, Postcoital; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
chemical_list: D003281:Contraceptives, Postcoital