Goodman Suzan R, El Ayadi Alison M, Rocca Corinne H, Kohn Julia E, Benedict Courtney E, Dieseldorff Jessica R, Harper Cynthia C
UCSF Bixby Center for Global Reproductive Health, 3333 California Street, UCSF Box 0744, San Francisco, CA 94143-0744, USA.
UCSF Bixby Center for Global Reproductive Health, 3333 California Street, UCSF Box 0744, San Francisco, CA 94143-0744, USA.
Contraception. 2018 Apr 18. doi: 10.1016/j.contraception.2018.04.009.
Unprotected intercourse is common, especially among teens and young women. Access to intrauterine device (IUD) as emergency contraception (EC) can help interested patients more effectively prevent unintended pregnancy and can also offer ongoing contraception. This study evaluated young women's awareness of IUD as EC and interest in case of need.
We conducted a secondary analysis of data from young women aged 18-25 years, not desiring pregnancy within 12 months, and receiving contraceptive counseling within a cluster-randomized trial in 40 US Planned Parenthood health centers in 2011-2013 (n=1500). Heath centers were randomized to receive enhanced training on contraceptive counseling and IUD placement, or to provide standard care. The intervention did not focus specifically on IUD as EC. We assessed awareness of IUD as EC, desire to learn more about EC and most trusted source of information of EC among women in both intervention and control groups completing baseline and 3- or 6-month follow-up questionnaires (n=1138).
At follow-up, very few young women overall (7.5%) visiting health centers had heard of IUD as EC. However, if they needed EC, most (68%) reported that they would want to learn about IUDs in addition to EC pills, especially those who would be very unhappy to become pregnant (adjusted odds ratio [aOR], 1.3; 95% confidence interval, 1.0-1.6, p<.05). Most (91%) reported a doctor or nurse as their most trusted source of EC information, over Internet (6%) or friends (2%), highlighting providers' essential role.
Most young women at risk of unintended pregnancy are not aware of IUD as EC and look to their providers for trusted information. Contraceptive education should explicitly address IUD as EC.
Few young women know that the IUD can be used for EC or about its effectiveness. However, if they needed EC, most reported that they would want to learn about IUDs in addition to EC pills, especially those very unhappy to become pregnant. Contraceptive education should explicitly address IUD as EC.
无保护性行为很常见，尤其是在青少年和年轻女性中。获得宫内节育器（IUD）作为紧急避孕（EC）的手段可以帮助有意愿的患者更有效地预防意外怀孕，并且还能提供持续的避孕效果。本研究评估了年轻女性对IUD作为紧急避孕方法的知晓情况以及在有需要时的兴趣。
我们对2011 - 2013年在美国40家计划生育健康中心进行的一项整群随机试验中的18 - 25岁年轻女性的数据进行了二次分析，这些女性在12个月内不想要怀孕且接受了避孕咨询（n = 1500）。健康中心被随机分为接受关于避孕咨询和IUD放置的强化培训组，或提供标准护理组。该干预措施并未专门针对IUD作为紧急避孕方法。我们评估了在完成基线以及3个月或6个月随访问卷的干预组和对照组女性中，对IUD作为紧急避孕方法的知晓情况、想要了解更多紧急避孕知识的意愿以及最信任的紧急避孕信息来源（n = 1138）。
在随访时，总体上很少有前往健康中心的年轻女性（7.5%）听说过IUD可作为紧急避孕方法。然而，如果她们需要紧急避孕，大多数（68%）报告称除了紧急避孕药之外，她们还想了解IUD，尤其是那些如果怀孕会非常不高兴的女性（调整后的优势比[aOR]，1.3；95%置信区间，1.0 - 1.6，p <.05）。大多数（91%）报告称医生或护士是她们最信任的紧急避孕信息来源，超过互联网（6%）或朋友（2%），这突出了提供者的重要作用。
大多数有意外怀孕风险的年轻女性并不知晓IUD可作为紧急避孕方法，而是向她们的提供者寻求可靠信息。避孕教育应明确提及IUD可作为紧急避孕方法。
很少有年轻女性知道IUD可用于紧急避孕或其有效性。然而，如果她们需要紧急避孕，大多数报告称除了紧急避孕药之外，她们还想了解IUD，尤其是那些如果怀孕会非常不高兴的女性。避孕教育应明确提及IUD可作为紧急避孕方法。
