SH:24, London, UK.
SH:24, London, UK.
Contraception. 2023 Jun;122:109992. doi: 10.1016/j.contraception.2023.109992. Epub 2023 Feb 26.
Our study aimed to describe users of a free online contraception service, compare online emergency contraceptive pill (ECP) users with online oral contraceptive (OC) users, and describe patterns of use of online ECP and OC over time, including transition from ECP to more effective forms of contraception.
Analysis of routinely collected, anonymized data from a large, publicly funded, online contraceptive service in the United Kingdom from April 1, 2019 to October 31, 2021.
The online service provided 77,447 prescriptions during the study period. About 84% for OC and 16% for ECP, of which 89% were ulipristal acetate. ECP users were younger, lived in more deprived areas, and were less likely to be of white ethnicity than OC users. About 53% ordered OC only, but 37% ordered both ECP and OC. Among those prescribed both OC and ECP (n = 1306), 40% had one method as dominant, 25% appeared to move from one method to the other (11% ECP to OC, 14% OC to ECP), and 35% continued to use both methods.
Online services are accessible to diverse young populations. While the majority of users order OC only, our study suggests that where there is free, online access to both OC and ECP, and those ordering ECP are always offered free OC, transition to more effective ongoing forms of contraception is uncommon. Further research is needed to understand whether online access to ECP increases its attractiveness and reduces likelihood of transition to OC.
This study demonstrates that free, online contraceptive services are accessible to ethnically and socioeconomically diverse users. It identifies a subgroup of contraceptive users who combine use of OC and ECPs over time, and suggests that improved access to ECP may alter contraceptive choices.
本研究旨在描述一个免费在线避孕药具服务的用户，比较在线紧急避孕药（ECP）使用者和在线口服避孕药（OC）使用者，并描述 ECP 和 OC 的使用模式随时间的变化，包括从 ECP 向更有效的避孕方法的转变。
对英国一个大型公共资助的在线避孕药具服务机构在 2019 年 4 月 1 日至 2021 年 10 月 31 日期间收集的常规匿名数据进行分析。
在研究期间，在线服务提供了 77447 份处方。大约 84%用于 OC，16%用于 ECP，其中 89%为乌利司他酮。ECP 用户更年轻，居住在更贫困的地区，并且种族为白人的比例低于 OC 用户。大约 53%仅订购 OC，但 37%同时订购 ECP 和 OC。在同时开处 OC 和 ECP 的人中（n=1306），40%有一种方法占主导地位，25%似乎从一种方法转向另一种方法（11%从 ECP 转为 OC，14%从 OC 转为 ECP），35%继续同时使用两种方法。
在线服务对不同的年轻人群是可及的。虽然大多数用户仅订购 OC，但我们的研究表明，在免费、在线提供 OC 和 ECP 的情况下，并且对订购 ECP 的人总是免费提供 OC 的情况下，向更有效的持续避孕方法的转变并不常见。需要进一步研究，以了解在线获取 ECP 是否会增加其吸引力并降低向 OC 转变的可能性。
本研究表明，免费的在线避孕药具服务对种族和社会经济背景不同的用户是可及的。它确定了一个在一段时间内同时使用 OC 和 ECP 的避孕用户亚组，并表明改善 ECP 的获取途径可能会改变避孕选择。
