Adolescent and Young Adult Women's Use of Emergency Contraception

Study Objective: To determine differences in the use of emergency contraception (EC) between adolescent (11-17 years old) and young adult women (18-24 years old) in an insured, population based cohort. Design and Participants: Females 11-24 years old were divided into two groups: adolescents (11-17) and young adults (18-24) at their first captured EC prescription fill. A medical record review followed. Main Outcome Measures: The main outcomes of our study were reason for EC use, timing of EC use, and repeat use. Chi-square tests were used to compare dichotomous variables between groups by age and for ever vs repeat use. An independent t-test was used to compare continuous variables. A person-time analysis was used to compare rates of repeat use. Results: 344 women were identified as having filled at least one prescription for an EC drug. Among ever users, adolescents were more likely than young adults to cite no contraception as their reason for seeking EC (30% for 11-17 and 24% for 18-24 year olds; P = 0.38). For both ever and repeat users, young adults reported condom failure as their main reason for seeking EC. We calculated t-tests on the hours since unprotected sex. For adolescents the mean was 42 hours and for young adults the mean was 34 hours (P = 0.13). Both are within the recommended 72-hour window for administration and were not significantly different. The rate of repeat use was essentially the same for both age groups. Conclusions: We found that adolescent use of EC was similar to young adult use and support the recommendation that 17-year-olds have behind-the-counter access to EC.