Awareness and knowledge regarding emergency contraception in Berlin adolescents

Abstract

Background: Lack of information has been described as a major factor in non-use of oral emergency contraception (EC) following unprotected intercourse. Despite the ongoing vociferous debate on liberalisation of access, little evidence is available on EC knowledge in Germany, particularly among adolescents.

Methods: We conducted a cross-sectional survey among ninth graders in convenience sample of 13 Berlin schools. We assessed perceived and actual knowledge on the effectiveness, timeframe and availability of EC and on pregnancy risk in six scenarios.

Results: A total of 1177 students between 13 and 16 years of age participated. Mean age was 14.6 years (standard deviation 0.67); 51.4% of participants were male. Whilst 8.7% had never heard of EC, 38.6% knew of its effectiveness, but only 12.7% knew the timeframe for EC. Of the sources of EC, only gynaecologists were widely known. Most students correctly evaluated pregnancy risk in given scenarios. Girls were more knowledgeable on most topics except for pregnancy risk. Attending a school of lower academic standard and being of immigrant background was associated with lower knowledge on the majority of items.

Conclusions: Generally, students were aware of the existence of EC, but many lacked the knowledge of when to take it and how to access it. Especially in the light of the recent liberalisation of EC access in Germany, increased educational efforts are warranted to ensure that the population has the knowledge necessary to make a truly informed choice regarding its use.

Chinese abstract

背景：对紧急避孕药不了解被认为是在无保护性行为后不使用口服紧急避孕药（EC）的主要原因。尽管关于自由化的讨论持续激烈, 但在德国尤其是青少年中, 没有EC认知度相关的证据支持。

方法：我们在柏林13所学校的9年级学生中进行了一项随机抽样的横断面调查, 评估青少年对于EC的有效性、时间窗、适应证以及6个场景中妊娠风险的感知和实际了解。

结果：研究共纳入1177名13至16岁的青少年。平均年龄14.6岁（标准差0.67）, 其中51.4%是男生。参与者中, 8.7%从未听说过EC, 38.7%知道EC的有效性, 但只有12.7%了解EC的服用时间窗。关于获取EC的来源, 仅有妇科医生被广泛知晓。大多数学生能在给予的场景中做出正确的妊娠风险判断。女生在除了妊娠风险外的大多话题方面都具备更多的知识。所在学校学术水平较低、移民背景等因素与大多数调查内容的了解程度低相关。

结论：总体来说, 学生知道EC的存在, 但很多学生缺乏何时服用EC与如何获得EC等知识。尤其在德国, EC有可以自由获得的趋势, 因此需要加强教育力度, 以确保民众拥有必要的知识对其使用作出真正知情的选择。

Keywords:

• Adolescent health
• adolescents
• emergency contraception
• health education
• sexual health

Acknowledgements

This study is part of a project to improve the sexual health knowledge of Berlin adolescents, partly funded by the German Federal Ministry of Education and Research. The authors express their gratitude to all schools and students participating in this study. The authors acknowledge the contribution of Werner Brannath (Competence Centre for Clinical Trials, University of Bremen) in cross-checking the methodology and all statistical analyses included in this article.

Disclosure statement

The authors declare no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This study is part of a project to improve the sexual health knowledge of Berlin adolescents, partly funded by the German Federal Ministry of Education and Research.