Contraception. 2014 May 24. pii: S0010-7824(14)00293-5. doi: 10.1016/j.contraception.2014.05.012. [Epub ahead of print]

IUDs as EC? Limited awareness and high reported acceptability: evidence from Argentina

Pichardo M, Arribas L, Coccio E, Heredia G, Jagroep S and Palermo T

Abstract:

Background: We explored knowledge and attitudes regarding the copper intrauterine device (IUD) as emergency contraception (EC) among women in Buenos Aires, Argentina.

Study design: We interviewed a convenience sample of women attending a family planning center at a public hospital. Participants were asked about knowledge and use of contraceptives, including EC (pre-script). Then they were given information about the IUD as EC and subsequently asked about acceptability of using the copper IUD as EC (post-script), the primary outcome in this analysis.

Results: We analyzed data on 273 women. While only 1.83% of participants knew the IUD served as EC at baseline, 79.85% said they would be willing to use the device as such if the need arose after given relevant information. Multivariate results from a pre-script revealed that women with low levels of education and those born outside of Argentina were less knowledgeable about EC. Only previous use of the IUD was associated with high levels of IUD knowledge. Post-script, results indicated that being Argentine [odds ratio (OR)=2.15, 95% confidence interval (CI) 1.21, 3.81] and previous IUD use (OR=2.12, 95% CI=1.07, 4.19) were positively associated with considering the IUD as EC. Nulliparity was negatively associated with willingness to use the IUD as EC (OR=0.44, 95% CI 0.22, 0.86).

Conclusions: We examined acceptability of the copper IUD as EC in a Latin American setting and found that, while prior levels of knowledg'e were low, acceptability of the IUD as EC was high. Implications for programming and policy include outreach and education regarding this highly effective method and advocacy to change existing regulations in Argentina prohibiting the use of IUD as EC.

Implications: After [being] given information about the IUD as a method of EC, women interviewed said they would be willing to use the IUD EC despite their limited prior knowledge of this method. With more widespread information and availability of the IUD as EC, more women may opt for this highly effective method, which can provide additional protection against unwanted pregnancy for up to 10 years.

Comment: A great paper, indicating that the use of an IUD as emergency contraceptive is not well known. However, when women hear about it, many prefer the method, because it also immediately provides them with contraception for a number of years. (HMV)