Abstract
Objectives
This study describes women's reasons for seeking ulipristal acetate (UPA) for emergency
contraception (EC) through the only authorized online retailer for UPA EC in the US.
Study design
Women aged 14 to 59 years, living in states that allow prescription medications to
be shipped from out-of-state, accessed the KwikMed online pharmacy between January
2011 and December 2015. After completing a medical eligibility screener, women answered
optional multiple-choice questions. To obtain UPA through KwikMed, individuals must
be female, 50 years of age or younger, not currently pregnant or breastfeeding and
not attempting to order UPA more than once within 30 days or more than four times
per year.
Results
Over the 5-year period, KwikMed provided 8019 prescriptions for UPA, and the number
of women using this service more than tripled over time. Among women who responded
to the survey questions (n=7133; response rate = 89%), most sought EC because of a condom failure (45.3%) or
because they did not use regular contraception (41.2%). More than half (53.5%) of
women reported that they chose UPA because of its effectiveness compared to levonorgestrel
EC pills, and 58.9% preferred ordering UPA online because they found it easier than
getting it from a doctor, clinic or pharmacy.
Conclusions
This study documents the importance of providing confidential services for acquiring
EC online. Benefits of online access include convenience, less embarrassment, avoiding
situations in which a provider might refuse to provide EC because of their own ideological
belief and more reliable availability for this time-sensitive contraceptive.
Implications
Though physical, logistical and societal barriers can restrict women's access to EC,
this study demonstrates that providing access to UPA online empowers women to obtain
EC when they need it.
Keywords
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Article info
Publication history
Published online: October 18, 2016
Accepted:
October 12,
2016
Received in revised form:
October 10,
2016
Received:
August 10,
2016
Footnotes
☆Funding sources: During the writing of this manuscript, the authors received support provided by the Population Research Infrastructure Program (P2CHD047879) awarded to the Office of Population Research at Princeton University by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
