Sexual and Contraceptive Behaviors among Adolescents Requesting Emergency Contraception.
OBJECTIVE
Unintended pregnancy rates in the United States remain high among adolescents. Emergency contraception (EC) provides the only option for pregnancy prevention after unprotected sex. To better define the population of adolescents who request and use EC pills, we performed a post hoc analysis of an over-the-counter simulation study of EC pills.


METHODS
Teen reproductive health clinics in 5 cities.


METHODS
Adolescents between the ages of 13 and 17 years who requested EC.


METHODS
Single-tablet levonorgestrel 1.5 mg.


METHODS
We calculated the correlations between age and baseline sexual and contraceptive behaviors. χ2Tests were used to compare behaviors of first-time and repeat EC users.


RESULTS
Overall, the most commonly reported contraceptive methods ever used were condoms, oral contraceptives, none, and withdrawal; the most common method ever used in each age group was no method for 13- to 14-year-olds and condom for 15-, 16-, and 17-year-olds. The percentage of participants who had never used contraception before requesting EC decreased with age (53% [20/28] of 13- to 14-year-olds vs 15% [10/65] of 17-year-olds). First-time EC users were more likely to report no previous contraceptive use compared with repeat EC users (42% [88/208] vs 10% [13/135]; P < .001). Regardless of age, the most commonly reported reason for requesting EC was nonuse of any contraceptive method (ie, "unprotected sex").


CONCLUSIONS
Adolescents who requested EC most commonly reported ever-use of contraceptive methods that rely on user adherence or no method at all, with younger adolescents more likely than older adolescents to have used no previous method. The provision of EC presents an opportunity to provide education and access to highly effective, long-term contraceptive methods.
Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, Georgia. Electronic address: ccwiak@emory.edu.
Carrie
C
Cwiak
Teva Global Medical Affairs, Department US Field Medical Affairs, Frazer, Pennsylvania.
Brandon
B
Howard
Teva Branded Pharmaceutical Products, R&D, Inc, Global Statistics, West Chester, Pennsylvania.
Jennifer
J
Hsieh
Teva Branded Pharmaceutical Products, R&D, Inc, Women's Health Clinical Research, Frazer, Pennsylvania.
Nancy
N
Ricciotti
Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; Group Health, Adolescent Medicine, Seattle, Washington.
Gina S
GS
Sucato
D000293:Adolescent; D000367:Age Factors; D016009:Chi-Square Distribution; D017280:Condoms / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods* / Q000523:psychology; D003268:Contraception Behavior; D044363:Contraception, Postcoital / Q000523:psychology* / Q000706:statistics & numerical data; D003276:Contraceptives, Oral / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000517:prevention & control / Q000523:psychology; D012725:Sexual Behavior; D014481:United States; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
D003276:Contraceptives, Oral; D016912:Levonorgestrel
Adolescents; Birth control; Emergency contraception