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Gaudineau, A., Ehlinger, V., Nic Gabhainn, S., Vayssiere, C., Arnaud, C. & Godeau, E.
British Journal Of Gynaecology
Use of emergency contraception pill by 15 years old girls: results from the international Health Behaviour in School-aged Children (HBSC) study.
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Adolescents contraceptive behaviour emergency contraceptive pill MULTILEVEL LOGISTIC-REGRESSION ADOLESCENTS TEENAGERS ACCESS PREGNANCY TRENDS
ObjectiveTo describe emergency contraceptive pill (ECP) use and variation across countries/regions; and to explore personal and contextual factors associated with ECP use and differences across countries/regions.DesignData were obtained from 11 countries/regions in the 2006 Health Behaviour in School-aged Children cross-sectional study.SettingData were collected by self-report questionnaire in school classrooms.PopulationThe analysis is based on 2118 sexually active 15-year-old girls.MethodsContraceptive behaviours were compared across countries/regions by chi-square tests. Individual factors related to ECP use were investigated with separate logistic regression models. Multilevel random-intercept models allowed the investigation of individual and contextual effects, by partitioning the variance into student, school and country/region levels.Main outcome measuresECP use at last sexual intercourse.ResultsECP use rate varied significantly across countries/regions. Poor communication with at least one adult (odds ratio [OR] 1.62 [1.12-2.36], P = 0.011) and daily smoking (OR 1.46 [1.00-2.11], P = 0.048) were independently associated with ECP use in comparison with condom and/or birth-control pill use. Sexual initiation at 14 years or later (OR 2.02 [1.04-3.93], P = 0.039), good perceived academic achievement (OR 1.69 [1.04-2.75], P = 0.035) and daily smoking (OR 1.63 [1.01-2.64], P = 0.045) were associated with higher levels of ECP use in comparison with unprotected girls. The country-level variance remained significant in both comparisons.ConclusionsThese data document the large heterogeneity in rates of ECP use between countries/regions. These differences could not be explained by individual or contextual factors, and raise further questions in relation to ECP access for adolescents and their education in its appropriate use.
DOI 10.1111/j.1471-0528.2010.02637.x
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