The 130th Annual Meeting of APHA

Abstract #49976

Susie Hoffman, DrPH¹, Mocha Rosenberg, MPH¹, Theresa M Exner, PhD², and Joanne E. Mantell, PhD, MSPH³. (1) HIV Center for Clinical & Behavioral Studies, NYS Psychiatric Institute and Columbia University, 1051 Riverside Drive - Unit 15, New York, NY 10032, 212 923-7281, hoffman@pi.cpmc.columbia.edu, (2) HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Dr. - Unit 15, New York, NY 10032, (3) HIV Center for Clinical & Behavioral Studies, NYS Psychiatric Institute/Columbia University, 1051 Riverside Drive, Unit 15, New York, NY 10032

Background: As a post-coital method, emergency contraception (EC) has the potential to decrease unintended pregnancies, but its impact on condom use is unknown. EC might reduce couples' motivation to use condoms. Alternatively, it may increase their motivation to use barrier methods for dual protection, with EC as a pregnancy prevention back-up.

Methods: This exploratory study was conducted in a NYC family planning (FP) agency that has a policy of routinely offering barrier method users a prescription for EC. Waiting room surveys (199) showed that 25% of women were at risk for both STDs and pregnancy and of them, 80% were using condoms inconsistently. We elicited the views of 24 women who desired to prevent pregnancy and felt at risk for HIV/STDs, including 8 women selected because they had used EC in the past. Semi-structured interviews were conducted, audio-taped, transcribed and thematically coded.

Results: Overall, both users and non-users of EC were enthusiastic about the option of post-coital contraception. Non-users were not well informed about its availability, use, potential side effects or whether it was a contraceptive or an abortifacient. Committed condom users thought that the availability of EC would increase their sense of security, but would not diminish their reliance on condoms. Non-regular condom users thought that EC availability would be unlikely to increase their commitment to use condoms.

Conclusion:. Prophylactically offering EC is not likely to decrease or increase condom use, but a dual protection strategy that incorporates EC may offer another option for women with dual risks.

Learning Objectives: At the conclusion of this presentation, the participant will be able to

• Explain how the availability of emergency contraception (EC) could be an important component of a dual protection strategy that relies on condoms as a single dual protection method.
• Explain how the availability of EC might influence couples to decrease condom use.
• Describe the experiences of EC users, including whether and how EC use influenced their subsequent choice of contraceptive.
• Explain what women who feel at dual risk believe will be the impact of prophylactic provision of EC on their choice of methods.

Keywords: STD Prevention, Contraception

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.