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Predictors of oral contraceptive continuation in young, urban women
Abstracts / Contraception 84 (2011) 302–336 with a comprehensive interviewer-administered 41-item OC knowledge questionnaire. The questionnaire covered six domains of OC knowledge: mechanism, effectiveness, use, side effects, risks and benefits. We ascertained OC continuation at 6 months. Results: OC knowledge scores amongst the 659 subjects were 56% correct at baseline and 60% correct at 6 months. Scores improved more among women receiving the educational text messages (pb.01). The 6-month OC continuation rate was 59%. In the unadjusted analyses, participants continuing OCs had higher knowledge scores at baseline (58% vs. 53%) and follow-up (63% vs. 57%) compared to OC discontinuers (pb.01 for both comparisons). In logistic regression models controlling for age group, race/ ethnicity, education and text message intervention group, knowledge scores at baseline (OR 1.04, 95% CI 1.00–1.09) and 6 months (OR 1.06, CI 1.02– 1.11) were associated with OC continuation. Conclusions: OC knowledge scores were low at baseline and 6 months. Greater knowledge of OCs was associated with OC continuation. While differences were statistically significant, the magnitudes of association between OC knowledge and continuation require further evaluation to determine clinical relevance.
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Methods: We obtained baseline demographic information, reproductive history and relationship history in young women enrolled in an OC continuation trial at a Planned Parenthood clinic in Brooklyn, NY. We called participants at 6 months to assess contraceptive continuation. Results: The 962 participants ranged in age from 13 to 25 years (mean 20.6± 2.6). They identified as African American (42%), Hispanic (27%), White (27%) and Asian (4%). We contacted 683 (71%) at 6 months. Characteristics associated with OC continuation in bivariate analyses included age, white race, years of education, employment status, cohabitation, previous OC use, age at coitarche, nulligravity, previous abortion, relationship satisfaction and partner knowledge of pill use. In logistic regression, increasing age, white race, relationship satisfaction, previous OC use and age at coitarche remained as predictors of OC continuation. Conclusions: In this group of young, urban women we identified several characteristics associated with OC continuation, most of which concur with the existing literature. Age of coitarche, however, is a new finding. Interventions targeting young women with early sexual debut may increase OC continuation in this population.
P49 P47
CORRELATION BETWEEN BMI AND DRUG DISTRIBUTION OF ORAL CONTRACEPTIVES Edelman A Oregon Health and Science University, Portland, OR, USA
UNINTENDED PREGNANCY AND OTHER BARRIERS TO HPV VACCINATION COMPLETION Perry R University of Illinois-Chicago, Chicago, IL, USA Harwood B, Cowett A, Yu MC, Pappo E
Westhoff C, Stanczyk F, Myrna M, Cherala G Objectives: Oral contraceptives (OC) are highly lipophilic and hence expected to partition into fat mass. However, obesity effects on drug pharmacokinetics (PK), including drug distribution or ‘volume of distribution (Vd)’, are poorly understood. Our objective was to further examine the relationship between distribution of OC and BMI using pooled data from two prospective studies. Methods: A post hoc analysis was performed on the PK data obtained from reproductive-age women with obese (BMI N30 kg/m2; n=22) and normal BMI (BMI b25 kg/m2; n=24) who received OCs containing either 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) or 30 mcg EE/150 mcg LNG. Participants were admitted for 24- or 48-h inpatient stay at the end of the active tablets. Serial blood sampling over at least 24 h was performed to measure EE and LNG levels. PK parameters were computed using non-compartmental analysis and correlation testing with Pearson product-moment correlation. Results: No correlation was observed between BMI and EE Vd for either EE dose in both obese and normal BMI women (pN0.7 for all comparisons). Similarly, no correlation was found with the 150-mcg LNG dose in either BMI group (pN.2 for all comparisons). However, a correlation was observed between BMI and LNG Vd with a 100-mcg LNG dose in obese women (n=10, r=0.57, p=.05); a higher LNG Vd was associated with increasing BMI. Conclusions: Distribution of EE does not appear to be affected by BMI. A linear relationship may exist between BMI and LNG Vd in obese women at lower LNG doses.
Objectives: To identify predictors of human papillomavirus (HPV) vaccination completion among female adolescents and young women. Methods: We performed a retrospective cohort analysis of females aged 13 to 26 years presenting between June 2006 and May 2010 for HPV vaccination at gynecology and family medicine clinics. We abstracted data from the electronic medical record and used descriptive and comparative statistics. Results: A total of 507 females, mean age 22 years, received their first HPV vaccination in the study period. Sixty-six percent returned for the second vaccination, and 40% received the final vaccination. At the time of the first HPV vaccination, 94% were sexually active and 57% had a history of pregnancy. During the HPV vaccine series, 8% became pregnant. History of HPV disease was common, with 48% having abnormal cervical cytology. In a multivariable analysis, becoming pregnant was associated with failure to complete the series (OR 0.24; 95% CI 0.07–0.71). Compared to those with public insurance, those with private insurance (OR 3.09; 95% CI 1.48–6.68) and those paying out of pocket (OR 3.90; 95% CI 1.44–11.6) were more likely to complete the series. Age, race, contraception use, and history of colposcopy or dysplasia were not significantly associated with series completion. Conclusions: Young women receiving HPV vaccination are at risk for both unintended pregnancy and the sequelae of HPV disease. We found two barriers to HPV vaccination completion: pregnancy and public insurance as a marker of reduced access to care. Preventing unintended pregnancy and addressing financial barriers to care are important steps to increase rates of series completion.
P48 P50 PREDICTORS OF ORAL CONTRACEPTIVE CONTINUATION IN YOUNG, URBAN WOMEN Castaño P Columbia University Medical Center, New York, NY, USA Bynum J, Westhoff C Objectives: To determine characteristics associated with oral contraceptive (OC) continuation in women enrolled in a daily text message trial.
THE COPPER T380A IUD VS. ORAL LEVONORGESTREL FOR EMERGENCY CONTRACEPTION: A PROSPECTIVE OBSERVATIONAL STUDY Turok DK University of Utah, Salt Lake City, UT, USA Tacoma, WA, USA Jacobson JC, Simonsen SE, Gurtcheff SE, Trauscht-Van Horn J, Murphy PA
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Methods: We obtained baseline demographic information, reproductive history and relationship history in young women enrolled in an OC continuation trial at a Planned Parenthood clinic in Brooklyn, NY. We called participants at 6 months to assess contraceptive continuation. Results: The 962 participants ranged in age from 13 to 25 years (mean 20.6± 2.6). They identified as African American (42%), Hispanic (27%), White (27%) and Asian (4%). We contacted 683 (71%) at 6 months. Characteristics associated with OC continuation in bivariate analyses included age, white race, years of education, employment status, cohabitation, previous OC use, age at coitarche, nulligravity, previous abortion, relationship satisfaction and partner knowledge of pill use. In logistic regression, increasing age, white race, relationship satisfaction, previous OC use and age at coitarche remained as predictors of OC continuation. Conclusions: In this group of young, urban women we identified several characteristics associated with OC continuation, most of which concur with the existing literature. Age of coitarche, however, is a new finding. Interventions targeting young women with early sexual debut may increase OC continuation in this population.
P49 P47
CORRELATION BETWEEN BMI AND DRUG DISTRIBUTION OF ORAL CONTRACEPTIVES Edelman A Oregon Health and Science University, Portland, OR, USA
UNINTENDED PREGNANCY AND OTHER BARRIERS TO HPV VACCINATION COMPLETION Perry R University of Illinois-Chicago, Chicago, IL, USA Harwood B, Cowett A, Yu MC, Pappo E
Westhoff C, Stanczyk F, Myrna M, Cherala G Objectives: Oral contraceptives (OC) are highly lipophilic and hence expected to partition into fat mass. However, obesity effects on drug pharmacokinetics (PK), including drug distribution or ‘volume of distribution (Vd)’, are poorly understood. Our objective was to further examine the relationship between distribution of OC and BMI using pooled data from two prospective studies. Methods: A post hoc analysis was performed on the PK data obtained from reproductive-age women with obese (BMI N30 kg/m2; n=22) and normal BMI (BMI b25 kg/m2; n=24) who received OCs containing either 20 mcg ethinyl estradiol (EE)/100 mcg levonorgestrel (LNG) or 30 mcg EE/150 mcg LNG. Participants were admitted for 24- or 48-h inpatient stay at the end of the active tablets. Serial blood sampling over at least 24 h was performed to measure EE and LNG levels. PK parameters were computed using non-compartmental analysis and correlation testing with Pearson product-moment correlation. Results: No correlation was observed between BMI and EE Vd for either EE dose in both obese and normal BMI women (pN0.7 for all comparisons). Similarly, no correlation was found with the 150-mcg LNG dose in either BMI group (pN.2 for all comparisons). However, a correlation was observed between BMI and LNG Vd with a 100-mcg LNG dose in obese women (n=10, r=0.57, p=.05); a higher LNG Vd was associated with increasing BMI. Conclusions: Distribution of EE does not appear to be affected by BMI. A linear relationship may exist between BMI and LNG Vd in obese women at lower LNG doses.
Objectives: To identify predictors of human papillomavirus (HPV) vaccination completion among female adolescents and young women. Methods: We performed a retrospective cohort analysis of females aged 13 to 26 years presenting between June 2006 and May 2010 for HPV vaccination at gynecology and family medicine clinics. We abstracted data from the electronic medical record and used descriptive and comparative statistics. Results: A total of 507 females, mean age 22 years, received their first HPV vaccination in the study period. Sixty-six percent returned for the second vaccination, and 40% received the final vaccination. At the time of the first HPV vaccination, 94% were sexually active and 57% had a history of pregnancy. During the HPV vaccine series, 8% became pregnant. History of HPV disease was common, with 48% having abnormal cervical cytology. In a multivariable analysis, becoming pregnant was associated with failure to complete the series (OR 0.24; 95% CI 0.07–0.71). Compared to those with public insurance, those with private insurance (OR 3.09; 95% CI 1.48–6.68) and those paying out of pocket (OR 3.90; 95% CI 1.44–11.6) were more likely to complete the series. Age, race, contraception use, and history of colposcopy or dysplasia were not significantly associated with series completion. Conclusions: Young women receiving HPV vaccination are at risk for both unintended pregnancy and the sequelae of HPV disease. We found two barriers to HPV vaccination completion: pregnancy and public insurance as a marker of reduced access to care. Preventing unintended pregnancy and addressing financial barriers to care are important steps to increase rates of series completion.
P48 P50 PREDICTORS OF ORAL CONTRACEPTIVE CONTINUATION IN YOUNG, URBAN WOMEN Castaño P Columbia University Medical Center, New York, NY, USA Bynum J, Westhoff C Objectives: To determine characteristics associated with oral contraceptive (OC) continuation in women enrolled in a daily text message trial.
THE COPPER T380A IUD VS. ORAL LEVONORGESTREL FOR EMERGENCY CONTRACEPTION: A PROSPECTIVE OBSERVATIONAL STUDY Turok DK University of Utah, Salt Lake City, UT, USA Tacoma, WA, USA Jacobson JC, Simonsen SE, Gurtcheff SE, Trauscht-Van Horn J, Murphy PA