contraceptives--postcoital and Chlamydia-Infections

To assess how a strategy to maximize access to emergency contraceptive pills would affect rates of pregnancy and sexually transmitted infections.. Sexually active women, 14-24 years old, were randomly assigned to two methods of access to emergency contraceptive pills: increased access (two packages of pills dispensed in advance with unlimited resupply at no charge) or standard access (pills dispensed when needed at usual charges). Participants were followed for 1 year to assess incidence of pregnancy, gonorrhea, chlamydia, and trichomonas.. The numbers of women enrolled in the increased and standard access groups were 746 and 744, respectively. More than 93% of participants completed a full year of follow-up. The incidence of pregnancy was similar in both groups (increased access group: 9.9/100 woman years, 95% confidence interval [CI] 7.7-12.6; standard access group: 10.5/100 woman years, 95% CI 8.2-13.2). Aggregate rates of gonorrhea, chlamydia, and trichomonas were also similar in the two groups (increased access group: 6.9/100 woman years, 95% CI 5.1-9.1; standard access group: 7.6/100 woman years, 95% CI 5.7-9.9). The increased access group used emergency contraceptive pills substantially more often and sooner after coitus than the standard access group. No other differences were noted between groups in self-reported measures of sexual behavior and contraceptive use.. This intensive strategy to enhance access to emergency contraceptive pills substantially increased use of the method and had no adverse impact on risk of sexually transmitted infections. However, it did not show benefit in decreasing pregnancy rates.. II-1.

Topics: Adolescent; Adult; Chlamydia Infections; Contraceptives, Postcoital; Female; Gonorrhea; Health Services Accessibility; Humans; Nevada; North Carolina; Pregnancy; Pregnancy Rate; Sexual Behavior; Trichomonas Vaginitis

Topics: Adolescent; Adult; Chlamydia Infections; Chlamydia trachomatis; Contraceptives, Postcoital; Female; Humans; Mass Screening; Pharmacies; Sexually Transmitted Diseases

A total of 838 women attending a large family planning clinic in Scotland for emergency contraception were offered screening for Chlamydia trachomatis infection. 569 were screened using ligase chain reaction test in first void urine at the time of presenting for emergency contraception and were retested 1 or 2 weeks later. Women aged under 20 and over 30 years were significantly more likely to decline to be tested than women aged 20 to 30. The prevalence of chlamydia was 7.6% in woman aged 24 or less, 5.3% in women aged 25 to 29, and 1.2% in women aged 30 or more. Only two women (< 1%) who tested negative at the time of using EC were positive 1 or 2 weeks later. Women under age 30 who use EC should be offered screening for chlamydia infection and testing at the time they attend for EC is adequate to detect the great majority of infected women.

Topics: Adolescent; Adult; Ambulatory Care Facilities; Chlamydia Infections; Chlamydia trachomatis; Condoms; Contraceptives, Postcoital; Female; Humans; Middle Aged; Safe Sex; Scotland

Two surveys were undertaken to review (1) provision of Chlamydia trachomatis screening by family planning (FP) clinics in the London region and (2) access to emergency contraception (EC) from genitourinary#10; medicine (GUM) clinics within the former North Thames region. The findings from the first survey suggest that there is insufficient screening (and treatment) in vulnerable groups attending FP clinics. Results#10; from the second survey show that hormonal EC is widely available from within GUM clinics, and those clinics also provide a range of other contraception services. However, these details may not be widely#10; recognised either by policymakers or the general public. #10;

Topics: Ambulatory Care Facilities; Chlamydia Infections; Chlamydia trachomatis; Contraceptives, Postcoital; Cross-Sectional Studies; England; Family Planning Services; Female; Health Services Accessibility; Humans; London; Mass Screening; Practice Patterns, Physicians'; Surveys and Questionnaires