1st article today: (technical issues 3 weeks ago….)

Factors Associated With Interest in Same-Day Contraception Initiation Among Females in the Pediatric Emergency Department

J Adolesc Health. 2016 Feb;58(2):154-9. doi: 10.1016/j.jadohealth.2015.10.016.

Background: Adolescents in the ED often report factors associated with increased pregnancy risk, including violence victimization and lack of utilization of regular care. The ED is an important nontraditional setting for targeted pregnancy prevention interventions. Information is lacking about potential contraception uptake among adolescents.

Adolescent relationship abuse (ARA) has been associated with a number of behaviors that increase pregnancy risk, including inconsistent condom use, earlier sexual debut and substance use during sexual behavior.

Purpose: To assess interest in same-day initiation of a hormonal contraceptive method and to describe factors associated with this interest.

Hypothesis: Adolescents in the pediatric ED reporting ARA will have a higher rate of interest in same day initiation of hormonal contraceptives.

Method: Cross sectional survey of ED adolescents in a Midwestern children’s hospital system. This ED has >70,000 annual visits, 67% nonwhite patients, 71% with public or no insurance.

Population: Female patients 14-19 with any chief complaint and self-reported previous sexual activity of any type. Complaints involving sexual assault or psych issues were excluded; wards of the state were excluded. 171 of 484 adolescents approached completed the survey and were deemed eligible.

Results

-95% of adolescents did not wish to become pregnant within the next year

-58% of adolescents reported using a condom at last intercourse

-75% had had sex in the previous 3 months

-10% reported last vaginal intercourse less than 5 days prior; among these, 53% either used no method or withdrawal to prevent pregnancy

-36% reported victimization of any type, including adolescent relationship abuse (ARA), reproductive coercion or forcible rape

-43% were currently using hormonal contraception

-70% of those not currently using any hormonal contraception were interested in same-day initiation of some type of hormonal contraception

-Violence victimization was not associated with interest in contraception initiation

Future directions: Stay tuned. Breathe deeply.

Alex