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Improved access to emergency contraception did not increase risky sexual behaviour in adolescents

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 Q In adolescents, does easier access to emergency contraception (EC) increase rates of unprotected intercourse, sexually transmitted disease (STD), and pregnancy?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Emergency medicine ★★★★★★☆ Gynaecology ★★★★★★☆


Embedded ImageDesign:

subgroup analysis of a randomised controlled trial.

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded {data collectors, healthcare providers, outcome assessors, and all data analysts}.*

Embedded ImageFollow up period:

6 months.

Embedded ImageSetting:

4 clinics in the San Francisco Bay Area, California, USA.

Embedded ImageParticipants:

from a larger trial of 2117 women, 964 adolescents who were 15–19 years of age (mean age 17 y); were not pregnant and did not wish to become pregnant; and were using oral contraceptives, condoms, other barriers, or no contraceptive methods. Exclusion criteria: request for EC or unprotected intercourse in the previous 3 days.

Embedded ImageIntervention:

pharmacy access to EC (n = 372), advance provision of 3 packs of levonorgestrel (Plan B) EC (n = 379), and clinic access (n = 142).

Embedded ImageOutcomes:

contraceptive behaviours, STDs, and pregnancy.

Embedded ImagePatient follow up:

93% …

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  • * See glossary

  • For correspondence: Dr C C Harper, University of California, San Francisco, CA, USA. harperc{at}

  • Sources of funding: Compton Foundation Inc; Open Society Institute; Walter Alexander Gerbode Foundation; William and Flora Hewlett Foundation.

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