{"title":"在美国大学校园附近获取紧急避孕药具：多布斯诉杰克逊妇女健康组织案判决后各州当天紧急避孕药具供应情况比较","authors":"A Rashid, K Patel, M Wood, C Chuang","doi":"10.1016/j.contraception.2024.110641","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>We aimed to compare same-day emergency contraception (EC) availability near US universities in abortion-restrictive versus abortion-protective states after <em>Dobbs v Jackson Women’s Health Organization</em>.</div></div><div><h3>Methods</h3><div>Using a “mystery shopper” script, we conducted a cross-sectional telephone survey in 2023 to ascertain same-day OTC EC availability in pharmacies near universities in abortion-protective states (NY, CA), and abortion-restrictive states (TX, AK). Multivariable analysis modeled likelihood of same-day EC availability by state abortion status, controlling for chain vs. non-chain pharmacies and urban or rural locations. Alternative pharmacy locations were obtained from pharmacies where EC was unavailable.</div></div><div><h3>Results</h3><div>Of the 402 pharmacies contacted, 75% had same-day OTC EC availability, representing 65% of pharmacies in abortion-restrictive vs. 85% in abortion-protective states (p<0.001). Chain pharmacies were more likely to have same-day availability than non-chain pharmacies (92% vs. 52%, p<0.001). In the adjusted analysis, EC was less likely to be available in abortion-restrictive states (adjusted OR (aOR) 0.31, 95% CI 0.17-0.56), and more likely in chain pharmacies (aOR 11.58, 95% CI 6.45-20.80). Of the 102 pharmacies where same-day EC was unavailable, 61 (59%) did not provide an alternative location: 74% were in abortion-restrictive states, while 26% were in abortion-protective states.</div></div><div><h3>Conclusions</h3><div>This study revealed same-day OTC EC availability near universities is lower in abortion-restrictive states compared to abortion-protective states. Fewer pharmacies in abortion-restrictive states compared to abortion-protective states provided an alternative pharmacy if OTC EC was unavailable. Incentives to increase OTC EC availability in non-pharmacy locations and encourage anticipatory purchase should be implemented on and near college campuses to reduce the risk of unintended pregnancy.</div></div>","PeriodicalId":10762,"journal":{"name":"Contraception","volume":"139 ","pages":"Article 110641"},"PeriodicalIF":2.8000,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"ACCESSING EMERGENCY CONTRACEPTION NEAR US COLLEGE CAMPUSES: A COMPARISON OF SAME-DAY EMERGENCY CONTRACEPTION AVAILABILITY BY STATE AFTER THE DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION DECISION\",\"authors\":\"A Rashid, K Patel, M Wood, C Chuang\",\"doi\":\"10.1016/j.contraception.2024.110641\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><div>We aimed to compare same-day emergency contraception (EC) availability near US universities in abortion-restrictive versus abortion-protective states after <em>Dobbs v Jackson Women’s Health Organization</em>.</div></div><div><h3>Methods</h3><div>Using a “mystery shopper” script, we conducted a cross-sectional telephone survey in 2023 to ascertain same-day OTC EC availability in pharmacies near universities in abortion-protective states (NY, CA), and abortion-restrictive states (TX, AK). Multivariable analysis modeled likelihood of same-day EC availability by state abortion status, controlling for chain vs. non-chain pharmacies and urban or rural locations. Alternative pharmacy locations were obtained from pharmacies where EC was unavailable.</div></div><div><h3>Results</h3><div>Of the 402 pharmacies contacted, 75% had same-day OTC EC availability, representing 65% of pharmacies in abortion-restrictive vs. 85% in abortion-protective states (p<0.001). Chain pharmacies were more likely to have same-day availability than non-chain pharmacies (92% vs. 52%, p<0.001). In the adjusted analysis, EC was less likely to be available in abortion-restrictive states (adjusted OR (aOR) 0.31, 95% CI 0.17-0.56), and more likely in chain pharmacies (aOR 11.58, 95% CI 6.45-20.80). Of the 102 pharmacies where same-day EC was unavailable, 61 (59%) did not provide an alternative location: 74% were in abortion-restrictive states, while 26% were in abortion-protective states.</div></div><div><h3>Conclusions</h3><div>This study revealed same-day OTC EC availability near universities is lower in abortion-restrictive states compared to abortion-protective states. Fewer pharmacies in abortion-restrictive states compared to abortion-protective states provided an alternative pharmacy if OTC EC was unavailable. Incentives to increase OTC EC availability in non-pharmacy locations and encourage anticipatory purchase should be implemented on and near college campuses to reduce the risk of unintended pregnancy.</div></div>\",\"PeriodicalId\":10762,\"journal\":{\"name\":\"Contraception\",\"volume\":\"139 \",\"pages\":\"Article 110641\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-10-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Contraception\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0010782424003366\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Contraception","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0010782424003366","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
方法使用 "神秘顾客 "脚本，我们在 2023 年进行了一次横断面电话调查，以确定在保护人工流产州（纽约州、加利福尼亚州）和限制人工流产州（德克萨斯州、亚利桑那州）的大学附近的药店是否提供当天的 OTC EC。多变量分析根据各州的人工流产状况，对当天是否有药店提供避孕药进行了建模，并对连锁药店与非连锁药店以及城市或农村地区进行了控制。结果 在所联系的 402 家药店中，75% 的药店可提供当天的 OTC EC，其中限制堕胎州的药店占 65%，而保护堕胎州的药店占 85%（p<0.001）。与非连锁药店相比，连锁药店更有可能提供当天可用的产品（92% 对 52%，p<0.001）。在调整后的分析中，限制堕胎的州提供安琪儿的可能性较低（调整后 OR (aOR) 0.31，95% CI 0.17-0.56），而连锁药店提供安琪儿的可能性较高（aOR 11.58，95% CI 6.45-20.80）。在 102 家无法提供当天 EC 的药店中，61 家（59%）没有提供替代地点：74%的药店位于限制堕胎的州，26%的药店位于保护堕胎的州。与堕胎保护州相比，限制堕胎州的药店在无法获得非处方药避孕药时提供替代药店的数量较少。应在大学校园内及附近实施激励措施，增加非药房地点的非处方药物避孕药具供应，并鼓励预期购买，以降低意外怀孕的风险。
ACCESSING EMERGENCY CONTRACEPTION NEAR US COLLEGE CAMPUSES: A COMPARISON OF SAME-DAY EMERGENCY CONTRACEPTION AVAILABILITY BY STATE AFTER THE DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION DECISION
Objectives
We aimed to compare same-day emergency contraception (EC) availability near US universities in abortion-restrictive versus abortion-protective states after Dobbs v Jackson Women’s Health Organization.
Methods
Using a “mystery shopper” script, we conducted a cross-sectional telephone survey in 2023 to ascertain same-day OTC EC availability in pharmacies near universities in abortion-protective states (NY, CA), and abortion-restrictive states (TX, AK). Multivariable analysis modeled likelihood of same-day EC availability by state abortion status, controlling for chain vs. non-chain pharmacies and urban or rural locations. Alternative pharmacy locations were obtained from pharmacies where EC was unavailable.
Results
Of the 402 pharmacies contacted, 75% had same-day OTC EC availability, representing 65% of pharmacies in abortion-restrictive vs. 85% in abortion-protective states (p<0.001). Chain pharmacies were more likely to have same-day availability than non-chain pharmacies (92% vs. 52%, p<0.001). In the adjusted analysis, EC was less likely to be available in abortion-restrictive states (adjusted OR (aOR) 0.31, 95% CI 0.17-0.56), and more likely in chain pharmacies (aOR 11.58, 95% CI 6.45-20.80). Of the 102 pharmacies where same-day EC was unavailable, 61 (59%) did not provide an alternative location: 74% were in abortion-restrictive states, while 26% were in abortion-protective states.
Conclusions
This study revealed same-day OTC EC availability near universities is lower in abortion-restrictive states compared to abortion-protective states. Fewer pharmacies in abortion-restrictive states compared to abortion-protective states provided an alternative pharmacy if OTC EC was unavailable. Incentives to increase OTC EC availability in non-pharmacy locations and encourage anticipatory purchase should be implemented on and near college campuses to reduce the risk of unintended pregnancy.
期刊介绍：
Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.
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