Does the knowledge of emergency contraception affect its use among high school adolescents?

Chofakian, Christiane Borges do Nascimento; Borges, Ana Luiza Vilela; Sato, Ana Paula Sayuri; Alencar, Gizelton Pereira; Santos, Osmara Alves dos; Fujimori, Elizabeth

doi:10.1590/0102-311X00188214

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ARTICLE • Cad. Saúde Pública 32 (01) • 2016 • https://doi.org/10.1590/0102-311X00188214 copy

Does the knowledge of emergency contraception affect its use among high school adolescents?

O conhecimento da contracepção de emergência afeta seu uso entre adolescentes do Ensino Médio do Brasil?

¿El conocimiento de la contracepción de emergencia afecta a su uso entre adolescentes de enseñanza media en Brasil?

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to test how knowledge on emergency contraception (according to age at sexual initiation, type of school, and knowing someone that has already used emergency contraception) influences the method’s use. This was a cross-sectional study in a probabilistic sample of students 15-19 years of age enrolled in public and private middle schools in a medium-sized city in Southeast Brazil (n = 307). Data were collected in 2011 using a self-administered questionnaire. A structural equations model was used for the data analysis. Considering age at sexual initiation and type of school, knowledge of emergency contraception was not associated with its use, but knowing someone that had used the method showed a significant mean effect on use of emergency contraception. Peer group conversations on emergency contraception appear to have greater influence on use of the method than knowledge itself, economic status, or sexual experience.

Postcoital Contraception; Sexual and Reproductive Health; Adolescent Health

Variables	n	%
Gender
Male	138	44.9
Female	169	55.1
Age (years)
15-16	171	55.7
17-19	136	44.3
Type of school
Public	236	76.9
Private	71	23.1
Currently dating
No	159	51.6
Yes	148	48.4
Age of sexual initiation (years)
≤ 14	125	40.7
≥ 15	182	59.3
Knowledge of someone who had already used EC
No	73	23.7
Yes	234	76.3
Knowledge of EC
QA: EC should be used before intercourse
Correct answer	256	83.5
Incorrect answer	51	16.5
QB: EC prevents STDs
Correct answer	246	80.3
Incorrect answer	61	19.7
QC: If vomiting occurs within 2 hours after ingestion of EC, the dose should be repeated
Correct answer	68	22.1
Incorrect answer	239	77.9
QD: EC is more effective than other contraceptives (such as condoms, pill, IUD)
Correct answer	173	56.4
Incorrect answer	134	43.6
QE: EC is to be used within 5 days after unprotected intercourse
Correct answer	74	24.2
Incorrect answer	233	75.8
QF: EC can be used once a month
Correct answer	113	36.7
Incorrect answer	194	63.3
QG: EC is abortive
Correct answer	92	29.9
Incorrect answer	215	70.1
QH: EC should be used only during fertile period
Correct answer	137	44.5
Incorrect answer	170	55.5
QI: EC replaces the regular oral pill
Correct answer	131	42.7
Incorrect answer	176	57.3
QJ: When using EC, one is protected from getting pregnant until the next period
Correct answer	101	33.0
Incorrect answer	206	67.0
Previous EC use
No	130	42.3
Yes	177	57.7
Total	307	100.0

Confirmatory factor analysis	Complete model		Reduced model
Confirmatory factor analysis	λ	p-value	λ	p-value
QA: EC should be used before intercourse	0.663	< 0.001	0.663	< 0.001
QB: EC prevents STDs	0.764	< 0.001	0.779	< 0.001
QC: If vomiting occurs within 2 hours after ingestion of EC, the dose should be repeated	0.086	0.308
QD: EC is more effective than other contraceptives (such as condoms, pill, IUD)	0.480	< 0.001	0.475	< 0.001
QE: EC is to be used within 5 days after unprotected intercourse	0.189	0.019
QF: EC can be used once a month	0.462	< 0.001	0.438	< 0.001
QG: EC is abortive	0.333	< 0.001
QH: EC should be used only during fertile period	0.676	< 0.001	0.665	< 0.001
QI: EC replaces the regular oral pill	0.762	< 0.001	0.756	< 0.001
QJ: When using EC, one is protected from getting pregnant until the next period	0.611	< 0.001	0.630	< 0.001
RMSEA	0.046		0.069
CFI	0.952		0.954
TLI	0.938		0.930

Effects	Standardized coefficient	Standard error	p-value	OR	95%CI
Knowledge of EC by
QA: EC should be used before intercourse *	0.673	0.087	< 0.001
QB: EC prevents STDs	0.762	0.074	< 0.001
QD: EC is more effective than other contraceptives (such as condoms, pill, IUD)	0.462	0.076	< 0.001
QF: EC can be used once a month	0.439	0.076	< 0.001
QH: EC should be used only during fertile period	0.676	0.067	< 0.001
QI: EC replaces the regular oral pill	0.762	0.072	< 0.001
QJ: When using EC, one is protected from getting pregnant until the next period	0.651	0.074	< 0.001
Knowledge of EC
Type of school	0.282	0.055	< 0.001
Age of sexual initiation	0.140	0.066	0.032
Knowledge of someone who had already used EC	0.187	0.069	0.007
Age at sexual initiation
Type of school	0.181	0.041	< 0.001
Knowledge of someone who had already used EC	0.024	0.068	0.720
Use of EC
Knowledge of EC	0.129	0.089	0.150	1.17	0.95-1.44
Type of school	-0.093	0.065	0.151	0.64	0.35-1.18
Age of sexual initiation	-0.052	0.066	0.430	0.93	0.78-1.11
Knowledge of someone who had already used EC	0.379	0.061	< 0.001	5.93	3.15-11.18

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[1] Correspondence
C. B. N. Chofakian. Escola de Enfermagem, Universidade de São Paulo. Av. Dr. Enéas de Carvalho Aguiar 419, São Paulo, SP 05403-000, Brasil. christianeborges@gmail.com