202720 Knowledge regarding oral contraceptive use, risks and benefits among clinic and pharmacy users in El Paso, Texas, and the impact of written information

Wednesday, November 11, 2009: 8:50 AM

Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
Sarah McKinnon, MPH , Department of Sociology, Population Research Center, University of Texas-Austin, Austin, TX
Kristine Hopkins, PhD , Population Research Center, University of Texas at Austin, Austin, TX
Jon Amastae, PhD , Center for Inter-American and Border Studies, University of Texas at El Paso, El Paso, TX
Joseph E. Potter, PhD , Population Research Center, University of Texas at Austin, Austin, TX
The Border Contraceptive Access Study aims to understand contraceptive use among women in El Paso, Texas, who have the option to obtain oral contraceptives (OCs) over-the-counter (OTC) from Mexican pharmacies or from US public clinics. We asked 533 clinic and 515 pharmacy users a series of questions about pill use, side effects, warning signs, non-contraceptive benefits, and contraindications. Half of women in each group were randomized to receive an informational leaflet on OCs following the interview. After a three month period, women were re-interviewed and asked similar knowledge questions. At baseline, 93% believed OCs need to be taken daily at the same time, and 54% knew to use a back-up method after missing three consecutive pills. Fifty percent thought women needed a break from OC use in order to “rest” their body. While 73%-85% recognized severe symptoms as warning signs, only 30-55% correctly identified common, non-dangerous pill-related symptoms. 95%-96% knew OCs do not protect against STIs/HIV, but far fewer reported that OCs prevent some cancers (35%) and can improve acne (15%). Very few women were able to identify common contraindications. In regression analyses, women who were clinic users, had completed high school, were US-born, and nulliparous were more likely to answer correctly (p<0.001). There was no improvement in knowledge among women given the leaflet. Although basic knowledge about OCs was good in this population, overall knowledge was better among clinic users. Future research should examine whether knowledge discrepancies impact quality of OC use. Efforts to make OCs OTC in the US must include a strong informational campaign.

Learning Objectives:
1. Identify the topics related to OC use about which participants were knowledgeable and those about which they were less knowledgeable 2. List the factors associated with superior knowledge related to OCs 3. Discuss the relevance of these findings to the potential availability of hormonal contraception over the counter in the US

Keywords: Contraceptives, Health Literacy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the research
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.