Division of Emergency Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
Division of Emergency Medicine, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts.
J Womens Health (Larchmt). 2020 May;29(5):622-626. doi: 10.1089/jwh.2019.7821. Epub 2020 Feb 19.
Contraception use reduces teen pregnancy, and long-acting reversible contraception is recommended as first-line treatment. Since many adolescents use the emergency department (ED) as a primary source of health care, it is a potential site of contraceptive counseling and provision. We surveyed female adolescents to assess desire for contraceptive counseling and initiation/change during an ED visit. This was a cross sectional study of a convenience sample of female ED patients aged 16-21 years in an urban pediatric ED. Participants completed an anonymous questionnaire about sexual health, contraceptive use, and interest in contraceptive counseling. The primary outcome was adolescent interest in starting/changing contraception during an ED visit. Three hundred eighty-one patients (mean age 19.1 ± 1.6 years) completed the survey. Most (80.5%) had been sexually active with a male partner, and 110 (28.2%) had previously been pregnant. Two-thirds were interested in discussing contraception and 22.5% were likely to start or change contraception during the ED visit. Those who wanted to start or change contraception were more likely to be sexually active with a male partner (93% vs. 82%, = 0.02) and to report that they were not satisfied with their current contraception (44% vs. 21%, = 0.0003). Fifteen (17%) of the adolescents likely to start or change contraception were interested in progestin implant initiation in the ED. Adolescents were interested in initiating or changing contraception during the ED visit, providing an important opportunity to discuss and initiate effective contraception.
避孕措施可降低青少年怀孕率，长效可逆避孕措施被推荐作为首选治疗方法。由于许多青少年将急诊部门 (ED) 作为主要的医疗保健来源，因此它是提供避孕咨询和服务的潜在场所。我们调查了女性青少年，以评估她们在 ED 就诊时对避孕咨询和开始/改变避孕方法的需求。这是一项横断面研究，对城市儿科 ED 中年龄在 16-21 岁的女性 ED 患者进行了便利抽样。参与者完成了一份关于性健康、避孕使用和对避孕咨询感兴趣的匿名问卷。主要结果是青少年在 ED 就诊时开始/改变避孕的意愿。381 名患者（平均年龄 19.1±1.6 岁）完成了调查。大多数（80.5%）与男性伴侣发生过性行为，110 名（28.2%）曾怀孕。三分之二的人有兴趣讨论避孕问题，22.5%的人可能在 ED 就诊期间开始或改变避孕方法。那些想要开始或改变避孕方法的人更有可能与男性伴侣发生性行为（93% vs. 82%，=0.02），并且报告说他们对当前的避孕方法不满意（44% vs. 21%，=0.0003）。15 名（17%）可能开始或改变避孕方法的青少年对 ED 中使用孕激素植入物感兴趣。青少年有兴趣在 ED 就诊时开始或改变避孕方法，这为讨论和开始有效避孕方法提供了重要机会。
