title: Contraceptive use among young women in Estonia: Association with contraceptive services.
abstract: OBJECTIVE
  Our study aimed to explore the association between the use of effective contraceptive methods and access to different contraceptive services, as well as to describe accessibility-related obstacles when using contraceptive services and satisfaction with those services.
  
  
  METHODS
  From a population-based cross-sectional study carried out in 2004 (response rate 53.8%), the data of 16- to 24-year-old women requiring contraception (N = 868) were analysed. Factors associated with the use of effective contraceptive methods and, specifically, hormonal methods, were explored using multiple logistic regression analysis.
  
  
  RESULTS
  Effective contraception was used by 75.1% of the respondents. The use of effective contraceptive methods was associated with school-based sexuality education (adjusted prevalence odds ratio 2.69; 95% confidence interval 1.32 - 5.50), visiting a youth-friendly clinic (YFC) (1.82; 1.03-3.23) or a private gynaecologist (2.08; 1.11-3.92). The use of hormonal methods was additionally associated with being a native Estonian speaker and visiting a family doctor. More than half of the respondents reported some obstacle in accessing contraceptive services. The highest satisfaction ratings were given to YFCs.
  
  
  CONCLUSIONS
  Steps to promote the use of services that are youth-friendly and associated with better uptake of effective contraceptive methods are needed among all 16- to 24-year-old women.
authors.affiliation: a * Department of Obstetrics and Gynaecology , University of Tartu , Tartu , Estonia.|b Tartu University Hospital Women's Clinic , Tartu , Estonia.|c Tartu Sexual Health Clinic , Tartu , Estonia.
authors.forename: Kai
authors.initials: K
authors.lastname: Part
authors.affiliation: d Department of Public Health , University of Tartu , Tartu , Estonia.
authors.forename: Inge
authors.initials: I
authors.lastname: Ringmets
authors.affiliation: a * Department of Obstetrics and Gynaecology , University of Tartu , Tartu , Estonia.|b Tartu University Hospital Women's Clinic , Tartu , Estonia.|c Tartu Sexual Health Clinic , Tartu , Estonia.
authors.forename: Made
authors.initials: M
authors.lastname: Laanpere
authors.affiliation: e Department of Epidemiology and Biostatistics , National Institute for Health Development , Tallinn , Estonia.
authors.forename: Mati
authors.initials: M
authors.lastname: Rahu
authors.affiliation: a * Department of Obstetrics and Gynaecology , University of Tartu , Tartu , Estonia.|b Tartu University Hospital Women's Clinic , Tartu , Estonia.
authors.forename: Helle
authors.initials: H
authors.lastname: Karro
mesh_terms: D000293:Adolescent; D017280:Condoms / Q000706:statistics & numerical data*; D003268:Contraception Behavior; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D004957:Estonia; D005193:Family Planning Services; D005194:Family Practice; D005260:Female; D006176:Gynecology; D006297:Health Services Accessibility; D006801:Humans; D007434:Intrauterine Devices / Q000706:statistics & numerical data*; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D012736:Sex Education / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003278:Contraceptives, Oral, Hormonal
keywords: Contraceptive services; Contraceptive use; Youth-friendly health services