薬局による緊急避妊への直接アクセスと,意図しない妊娠と性感染症への影響:ランダム化制御試験
Tina R Raine1, Cynthia C Harper, Corinne H Rocca
1Center for Reproductive Health Research and Policy, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA 94110, USA. rainet@obgyn.ucsf.edu
JAMA
|January 6, 2005
まとめ
薬局を通じて緊急避妊 (EC) に直接アクセスすることで,その使用が増加しましたが,事前に提供することがより効果的でした. 公共衛生への影響は,未充分利用と高水準の無防備性交による影響が限られている.
科学分野:
- 生殖器保健は,生殖器の健康についてです.
- 公衆衛生は公衆衛生である.
- クリニック・トライアル 臨床試験
背景:
- 予期せぬ妊娠の半分は,より良い緊急避妊 (EC) のアクセスと利用によって防ぐことができます.
- ECの現在のアクセス方法は,適切なタイミングでの使用に障害をもたらす可能性があります.
研究 の 目的:
- 薬局への直接的なアクセスとECの事前提供が生殖健康上の結果に与える影響を評価する.
- ECの使用,妊娠率,および若い女性の性感染症 (STIs) を評価するために.
主な方法:
- 15歳から24歳までの2117人の女性を対象としたランダム化比較試験です.
- 3つのグループの比較:ECへの薬局アクセス,ECの事前提供 (3パック),および標準的な診療所のアクセス (コントロール).
- 6ヶ月で測定されたアウトカムには,ECの使用,妊娠,性感染症,避妊薬の使用,性的行動が含まれていました.
主要な成果:
- 事前提供は,対照群 (21.0%) に比べてEC使用 (37.4%) を大幅に増加させ,薬局へのアクセス (24.2%) は増加しなかった.
- グループ間で妊娠率やSTI獲得の有意な違いは観察されなかった.
- 避妊薬とコンドームの使用,および性的行動は,すべての研究部門で一貫したままでした.
結論:
- 改善されたアクセスはECの利用を増加させる一方で,公衆衛生上の全体的な影響は,未充分利用と頻繁な無保護性交によって制限されています.
- 薬局へのアクセスの制限や事前提供は,避妊や性的行動に悪影響を及ぼさないため,ECのクリニックへのアクセスを制限することは,証拠によって支持されていません.
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