title: Trends in the use of emergency contraception in Britain: evidence from the second and third National Surveys of Sexual Attitudes and Lifestyles.
abstract: OBJECTIVE
  To examine the changes in the prevalence of, and the factors associated with, the use of emergency contraception (EC) in Britain between 2000 and 2010, spanning the period of deregulation and increase in pharmacy supply.
  
  
  METHODS
  Cross-sectional probability sample surveys.
  
  
  METHODS
  British general population.
  
  
  METHODS
  Data were analysed from the second and third British National Surveys of Sexual Attitudes and Lifestyles (Natsal), undertaken in 1999-2001 and 2010-12. Univariate and logistic regression analyses were used to measure change in EC use amongst sexually active women aged 16-44 years not intending pregnancy.
  
  
  METHODS
  Prevalence of EC use and factors associated with use.
  
  
  RESULTS
  Of the 5430 women surveyed in 1999-2001 and the 4825 women surveyed in 2010-12, 2.3 and 3.6%, respectively, reported using EC in the year prior to interview (P = 0.0019 for change over time). The prevalence of EC use increased amongst single women and those with higher educational attainment (adjusted odds ratio, aOR 1.51; 95% confidence interval, 95% CI 1.04-2.20; P = 0.0308). Increases in EC use were generally greater among women without behavioural risk factors, such as those with no history of abortion within 5 years (aOR 1.57; 95% CI 1.17-2.12; P = 0.0029), or those whose first heterosexual intercourse occurred after the age of 16 years (aOR 1.68; 95% CI 1.21-2.35; P = 0.0021). The increase in EC use was also more marked among women usually accessing contraception from retail sources than among those doing so from healthcare sources, which may reflect a use of condoms amongst EC users.
  
  
  CONCLUSIONS
  The increase in EC use among women in Britain in the first decade of the 21st century was associated with some, but not all, risk factors for unplanned pregnancy. Advice and provision may need to be targeted at those at highest risk of unplanned pregnancy.
  
  
  CONCLUSIONS
  Despite pharmacy access, only a small rise in emergency contraception use has been seen in Britain over 10 years.
authors.affiliation: University of Sydney, Sydney, NSW, Australia.
authors.forename: K I
authors.initials: KI
authors.lastname: Black
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Geary
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: French
authors.affiliation: University College London, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Leefe
authors.affiliation: University College London, London, UK.
authors.forename: C H
authors.initials: CH
authors.lastname: Mercer
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Glasier
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: W
authors.initials: W
authors.lastname: Macdowall
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Gibson
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.|University of Edinburgh, Edinburgh, UK.
authors.forename: J
authors.initials: J
authors.lastname: Datta
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Palmer
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Wellings
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001290:Attitude; D044363:Contraception, Postcoital / Q000706:statistics & numerical data* / Q000639:trends*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D006113:United Kingdom / Q000453:epidemiology
keywords: Emergency contraception; pharmacy access; risk factors; sexual behaviour; unplanned pregnancy