Internet availability of contraceptives

To measure the accessibility of contraceptive supplies over the Internet.

We performed an Internet search with the use of search engines and key words. We posed as consumers purchasing both prescription and over-the-counter contraceptive supplies. The number of clicks or web pages accessed, costs, shipping time, barriers to access, and prescription requirements were compared for selected birth control supplies.

More than 200 web sites were visited to locate at least one site where we could purchase each selected product. Contraceptive supplies, including male and female condoms, spermicides, vaginal sponges, intrauterine devices (IUDs), diaphragms, and cervical caps, were easily obtained without a prescription from foreign web sites. Oral contraceptive pills (OCs) were readily available online in November 1999; some sites had discontinued sales by February 2000, but OCs could still be purchased with no prescription in August 2000. None of the four prescription sites supplied physician or prescriber credentials. The contraceptive costs varied by vendor and product. A type of copper IUD could be purchased for less than $50.00, whereas a single package of emergency contraceptive pills cost $141.00 from one vendor because of prescription and shipping fees. Some emergency contraceptive pills ordered arrived after 72 hours or did not arrive and the purchase was not refunded. A levonorgestrel IUD was shipped without difficulty in December 1999, but a second device, ordered in February 2000, was temporarily impounded by United States Customs.

This method of contraceptive purchase is accessible, expensive, erratically regulated, and rapidly changing.