Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA.
Department of Internal Medicine, San Francisco General Hospital and University of California, San Francisco, San Francisco, CA, USA.
J Urban Health. 2010 Mar;87(2):244-253. doi: 10.1007/s11524-009-9418-8. Epub 2009 Dec 12.
Incarceration affords an opportunity to provide health care to populations with limited access to care. Women in this population are at high risk for experiencing unintended pregnancies. It is not known what proportion of these women engage in unprotected intercourse in the days prior to incarceration and therefore may benefit from being offered emergency contraception upon their arrest to decrease their risk of unintended pregnancies. We sought to describe the proportion and characteristics of newly arrested women who are eligible for and interested in taking emergency contraception by conducting a cross-sectional study in an urban county jail booking facility. A 63-item survey was administered to women ages 18-44 within 24 h of being arrested in San Francisco. Eighty-four (29%) women were eligible for emergency contraception. Of these, 48% indicated a willingness to take emergency contraception if offered. Half of the women eligible for emergency contraception expressed ambivalent attitudes about pregnancy. Women who had taken emergency contraception in the past were more likely to say they would accept it (45%) than women who had never used it (25%, p = .05). The strongest predictor of willingness to take emergency contraception was not having a misperception about its safety, efficacy, or mechanism of action (RR = 1.9, 95% CI 1.2-3.0). Seventy-one percent of all women indicated that they would accept an advance supply of emergency contraception upon release from jail. Emergency contraception counseling and provision should be offered to newly arrested women as a key reproductive and public health intervention for a traditionally marginalized, high-risk population.
监禁为那些难以获得医疗服务的人群提供了一个获得医疗保健的机会。在这个人群中，女性意外怀孕的风险很高。目前尚不清楚这些女性中有多少人在入狱前几天发生无保护性行为，因此，在她们被捕时提供紧急避孕措施可能会降低意外怀孕的风险，而这些女性可能会从中受益。我们试图通过在旧金山的一个城市县监狱登记处进行横断面研究，描述新被捕的符合条件且有兴趣服用紧急避孕药的女性的比例和特征。在旧金山被捕 24 小时内，对 18-44 岁的女性进行了 63 项问卷调查。84 名（29%）女性有资格服用紧急避孕药。其中，48%的人表示如果提供的话愿意服用紧急避孕药。有一半符合条件的女性对怀孕持矛盾态度。过去曾服用过紧急避孕药的女性更有可能表示愿意接受（45%），而从未服用过的女性则为 25%（p=0.05）。愿意服用紧急避孕药的最强预测因素不是对其安全性、有效性或作用机制的误解（RR=1.9，95%CI 1.2-3.0）。所有女性中有 71%表示，她们愿意在从监狱获释时接受紧急避孕药的预先供应。紧急避孕咨询和提供应作为一项关键的生殖和公共卫生干预措施，提供给新被捕的女性，以服务于这个传统上被边缘化的高风险人群。
