Patients Receiving Emergency Contraception (EC) at Sexually Transmitted Disease (STD) Clinics, New York City, 2006 – 2009

Background: Obstacles to women’s receipt of EC include lack of physician and public awareness of the method, and lack of patient access to physicians who will provide EC. In NYC STD clinics EC is a listed option on the reason for visit intake form and EC eligibility is assessed for all females during physician visits; EC is dispensed for immediate use by eligibles during the clinic visit. 

Objectives: To describe patients who have received EC and quantify the proportion of patients who receive EC as a result of eligibility ascertained during physician visits.

Methods: We analyzed BSTDC’s electronic health records for female patients between 15 and 44 years of age who received EC, January 2006 - September 2009. Patients who mentioned EC within their reason for visit or chief complaint were considered to be “EC-seekers” versus those patients who were determined to be eligible for same-day receipt of EC only by a physician’s assessment (“opportunistic-receivers”).

Results: A total of 12,330 females received EC; 10,441 (85%) EC seekers, 1,889 (15%) opportunistic-receivers. Overall, 37% (4,503) of patients who received EC were 15-19 years old, 38% (4,708) 20-24 and 16% (1,964) were 25-29. The majority of EC seekers and opportunistic-  receivers were Black non-Hispanic (53% and 57% respectively) and Hispanic (30%, both groups). Twenty percent (402) of 25-29 year olds were opportunistic-receivers compared with 15% (727) of 20-24 year olds and 10% (467) of 15-19 year old patients.

Conclusions: The majority of patients who received EC had specifically requested EC. Older patients were less likely to seek EC as a reason for visit or chief complaint; older patients may be less aware of EC.

Implications for Programs, Policy, and/or Research: Health care providers should assess patients for EC eligibility and not rely strictly on reason for visit and chief complaint.