Advance provision of emergency contraceptive pills reduces treatment delay: A randomised controlled trial among Swedish teenage girls

Abstract

Objective. To evaluate an intervention involving advance provision of emergency contraceptive pills (ECP) to Swedish teenage girls. Material and methods. Some 420 girls aged 15–19, requesting ECP at a local youth clinic were randomly assigned to intervention group (IG) (n = 214) or control group (CG) (n = 206). Both groups received ECP on request. The IG received one extra dose of ECP, condoms and an information leaflet regarding ECP and condom use. Main outcome measures were differences between IG and CG regarding ECP use, time span between unprotected intercourse and ECP intake, contraceptive use, and sexual risk taking. Questionnaires were completed at the initial visit, and the girls were followed up by structured telephone interviews 3 and 6 months later. Results. At the 3-month follow-up, girls in the IG were almost twice as likely to have used ECP compared to girls in the CG (IG: 24.0%, CG: 13%, p = 0.02), and they used it sooner after unprotected intercourse (mean time IG: 13.61 h, CG: 25.47 h, p = 0.007). Significant differences persisted 6 months after the intervention (ECP use IG: 31%, CG: 19%, p = 0.01; and mean time IG: 15.59 h, CG: 26.38 h, p = 0.006). No significant differences were found in the use of regular hormonal contraceptives or condoms at either follow-up. About 40% of the girls in both groups had risked pregnancy during the follow-up period, but only half of these had used ECP. Conclusions. This intervention shortened the time interval from unprotected intercourse to pill intake without jeopardising contraceptive use and without increasing sexual risk taking.

Abstract (Swedish)

Objective. To evaluate an intervention involving advance provision of emergency contraceptive pills (ECP) to Swedish teenage girls. Material and methods. Some 420 girls aged 15-19, requesting ECP at a local youth clinic were randomly assigned to intervention group (IG) (n=214) or control group (CG) (n=206). Both groups received ECP on request. The IG received one extra dose of ECP, condoms and an information leaflet regarding ECP and condom use. Main outcome measures were differences between IG and CG regarding ECP use, time span between unprotected intercourse and ECP intake, contraceptive use, and sexual risk taking. Questionnaires were completed at the initial visit, and the girls were followed up by structured telephone interviews 3 and 6 months later. Results. At the 3-month follow-up, girls in the IG were almost twice as likely to have used ECP compared to girls in the CG (IG: 24.0%, CG: 13%, p=0.02), and they used it sooner after unprotected intercourse (mean time IG: 13.61 h, CG: 25.47 h, p=0.007). Significant differences persisted 6 months after the intervention (ECP use IG: 31%, CG: 19%, p=0.01; and mean time IG: 15.59 h, CG: 26.38 h, p=0.006). No significant differences were found in the use of regular hormonal contraceptives or condoms at either follow-up. About 40% of the girls in both groups had risked pregnancy during the follow-up period, but only half of these had used ECP. Conclusions. This intervention shortened the time interval from unprotected intercourse to pill intake without jeopardising contraceptive use and without increasing sexual risk taking. © 2008 Taylor & Francis.

• author: Ekstrand Ragnar, Maria ; Larsson, Margareta ; Darj, Elisabeth and Tydén, Tanja
• publishing date: 2008
• type: Contribution to journal
• publication status: published
• keywords: Emergency contraception, RCT, Sweden, Teenage girls, contraceptive agent, levonorgestrel, postcoitus contraceptive agent, adolescent, adult, article, condom, controlled study, dose response, female, follow up, health center, human, intervention study, medical information, outcome assessment, pregnancy, priority journal, questionnaire, risk factor, sexual intercourse, Adolescent, Adult, Contraception Behavior, Contraception, Postcoital, Female, Humans, Interviews as Topic, Pilot Projects, Sexual Behavior, Time Factors
• in: Acta Obstetricia et Gynecologica Scandinavica
• volume: 87
• issue: 3
• pages: 354 - 359
• publisher: Wiley-Blackwell
• external identifiers: scopus:39849086346
• ISSN: 1600-0412
• DOI: 10.1080/00016340801936024
• language: English
• LU publication?: no
• id: 0bf5fb3c-f88d-4a96-abae-acc1f8eb8d5f
• date added to LUP: 2025-12-05 10:16:16
• date last changed: 2025-12-06 04:01:42