Health Services Research Division, Applied Research Department, Family Health International, Research Triangle Park, NC 27713, USA.
Contraception. 2010 Feb;81(2):133-9. doi: 10.1016/j.contraception.2009.08.015. Epub 2009 Sep 30.
Emergency contraception research has shifted from examining the public health effects of increasing access to emergency contraceptive pills (ECPs) to bridging ECP users to a regular contraceptive method as a way of decreasing unintended pregnancies.
In a randomized controlled trial in Jamaica, we tested a discount coupon for oral contraceptive pills (OCPs) among pharmacy-based ECP purchasers as an incentive to adopt (i.e., use for at least 2 months) this and other regular contraceptive methods. Women in the intervention and control arms were followed up at 3 and 6 months after ECP purchase to determine whether they adopted the OCP or any other contraceptive method. Condom use was recorded but was not considered a regular contraceptive due to its inconsistent use.
There was no significant difference in the proportion of women who adopted the OCP, injectable or intrauterine device in the control group or the intervention group (p=.39), and only 14.6% of the sample (mostly OCP adopters) used one of these three methods. Condom use was high (44.0%), demonstrating that ECP users were largely a condom-using group.
The discount coupon intervention was not successful. Although a small proportion of ECP users did bridge, the coupon did not affect the decision to adopt a regular contraceptive method. The study highlighted the need for bridging strategies to consider women's reproductive and sexual behaviors, as well as their context. However, in countries like Jamaica where HIV/AIDS is of concern and condom use is appropriately high, bridging may not be an optimal strategy.
紧急避孕措施的研究重点已从评估增加紧急避孕措施（ECP）可及性的公共卫生影响，转移到通过提供 ECP 来帮助使用者转用常规避孕方法，以减少非意愿妊娠。
在牙买加进行的一项随机对照试验中，我们对基于药房的 ECP 购买者使用口服避孕药（OCP）折扣券进行了测试，以此作为采用（即至少使用 2 个月）这种和其他常规避孕方法的激励措施。在购买 ECP 后 3 个月和 6 个月对干预组和对照组的女性进行随访，以确定她们是否采用了 OCP 或任何其他常规避孕方法。记录了避孕套的使用情况，但由于其使用不规律，故不将其视为常规避孕方法。
对照组和干预组采用 OCP、注射剂或宫内节育器的女性比例没有显著差异（p=.39），并且只有 14.6%的样本（主要是 OCP 使用者）使用了这三种方法中的一种。避孕套使用率很高（44.0%），这表明 ECP 用户主要是使用避孕套的群体。
折扣券干预措施并不成功。尽管一小部分 ECP 用户确实转用了常规避孕方法，但优惠券并没有影响采用常规避孕方法的决定。该研究强调了搭桥策略需要考虑女性的生殖和性行为以及其所处的环境。然而，在像牙买加这样关注艾滋病毒/艾滋病且避孕套使用率适当高的国家，搭桥可能不是一个最佳策略。
