Easy access to emergency contraception does not appear to encourage women to engage in risky behavior.1 In a study conducted in 2001-2003 in four California clinics, 2,117 women aged 15-24 were randomly assigned to either have access to emergency contraception from a pharmacy without a prescription, receive a supply of the pills to have on hand or be instructed to return to the clinic if they needed emergency contraception (the control group). Six months later, 29% overall said they had used emergency contraception since entering the study. The proportion did not differ between the pharmacy access and control groups (21-24%), but was significantly higher in the advance supply group (37%). No differences were found between controls and the other groups in frequency of unprotected intercourse, contraceptive use patterns, number of partners or consistency of condom use; however, reports of condom use at last intercourse were less common among women who had received pills in advance than among controls (47% vs. 54%). All three groups had similar rates of pregnancy and sexually transmitted disease during the study period. In the researchers' view, "it seems unreasonable" to require a clinic visit for the provision of emergency contraception.
1. Raine TR et al., Direct access to emergency contraception through pharmacies and effect on unintended pregnancy and STIs: a randomized controlled trial, Journal of the American Medical Association, 2005, 293(1):54-62.
JUST BETWEEN US WOMEN . . .
Evidence suggesting that women may contract bacterial vaginosis through sexual activity with female partners is growing.1 Between 1992 and 1995, some 708 new patients at two London sexual health clinics for lesbians and bisexual women completed surveys eliciting information on sexual risk factors. After undergoing genitourinary screening, 31% received a diagnosis of bacterial vaginosis, an often asymptomatic condition that may lead to infection, pregnancy complications and poor birth outcomes. In a multivariate analysis, women who had had more than 10 female sex partners had 60% higher odds of bacterial vaginosis than those who had had 1-5 female partners. The researchers conclude that the female partners of women being treated for bacterial vaginosis should be screened for the condition.
1. Bailey JV et al., Bacterial vaginosis in lesbians and bisexual women, Sexually Transmitted Diseases, 2004, 31(11): 691-694.
MEETING ICPD GOALS (OR NOT)
Ten years after the International Conference on Population and Development (ICPD), the extent to which the wealthiest donor countries have met their financial commitments to help achieve the goal of assuring access to basic reproductive health care for all men and women worldwide by 2015 varies widely.1 Four countries (Denmark, Norway, the Netherlands and Luxembourg) have met their assistance goals for 2005, but others have a long way to go. The fair share for 10 countries is about 2-7 times their current funding levels. Spain and Portugal would need to contribute at least 60 times their 2002 levels to meet their commitments. Together, donor nations need to triple their population assistance to meet ICPD's goal for 2005. More generally, when graded on a scale reflecting a variety of measures of financial and policy commitments to population assistance, 13 of 21 donor countries scored A's and B's, and the rest scored C's and D's. The United States makes a poor showing: It needs to triple its funding to pull its fair share, and its overall grade has slipped from B to C.
1. Population Action International, Progress & Promises: Trends in International Assistance for Reproductive Health and Population, Washington, DC: Population Action International, 2004.
ALMOST COMPLETE GUIDELINES
The Justice Department has issued the first-ever national guidelines aimed at helping state, local and tribal jurisdictions to respond "in the most competent, compassionate, and understanding manner possible" to individuals who have experienced sexual assault.1 Among other points, the guidelines stress the importance of victim-centere