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Y Ermias, I A Morgan, K M Curtis, M K Whiteman, L G Horton, L B Zapata
OBJECTIVE: Identify factors associated with healthcare providers' frequency of depot medroxyprogesterone acetate (DMPA) provision to adolescents. STUDY DESIGN: We analyzed data from surveys mailed to a nationally representative sample of public-sector providers and office-based physicians (n=1984). We estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of factors associated with frequent DMPA provision to adolescents in the past year. RESULTS: Although most providers (>95%) considered DMPA safe for adolescents, fewer reported frequent provision (89% of public-sector providers; 64% of office-based physicians)...
February 11, 2019: Contraception
Haiqi Chen, Dolores Mruk, Chris K C Wong, Bruno Silvestrini, C Yan Cheng
OBJECTIVE: The bioavailability of the non-hormonal male contraceptive adjudin is low in rats due to the blood-testis barrier (BTB). This study was designed to examine if F5-peptide, an endogenously produced reversible BTB modifier, could enhance the bioavailability of adjudin to affect spermatogenesis and provide a contraceptive effect in rats while reducing systemic toxicity. STUDY DESIGN: We overexpressed F5-peptide in adult male rats (n=10 rats; with 3 or 4 rats for each of the three different experiments noted in the three regimens) by intratesticular injection of a mammalian expression vector pCI-neo (pCI-neo/F5-peptide) vs...
February 11, 2019: Contraception
Justine Wu, Yael Braunschweig, Lisa H Harris, Willi Horner-Johnson, Susan D Ernst, Bethany Stevens
For the first time in the twenty-first century, we have an emerging body of research regarding contraceptive use among adult women with disabilities in the United States. We highlight key findings from population-based analyses that found higher odds of female sterilization and lower odds of long-acting reversible contraception (LARC) use among women with disabilities compared to their peers without disabilities. We consider potential reasons underlying these differences, including discriminatory attitudes and policies that restrict the sexual and reproductive autonomy of people with disabilities...
February 11, 2019: Contraception
Shona L Ray-Griffith, Divyan Chopra, Zachary N Stowe, Bradley C Martin
OBJECTIVE: To describe claims for contraceptive services among reproductive aged women filling chronic opioid prescriptions. STUDY DESIGN: Using a large US commercial claims database, IMS Lifelink+, we identified women aged 15-44years who filled chronic opioid prescriptions (defined as a 90day supply of opioids without a 30day gap over a 180day time period) and had continuous pharmacy and medical enrollment for at least 90days prior to and 180days following their index opiod prescription...
February 11, 2019: Contraception
Jessica M Sales, Ashley L Phillips, Ilyssa Tamler, Tatiana Munoz, Carrie Cwiak, Anandi N Sheth
OBJECTIVE: Family planning (FP) clinics are an ideal setting to disseminate information about pre-exposure prophylaxis (PrEP), but little is known about women's preferences for learning about PrEP in this setting. STUDY DESIGN: We surveyed 500 women seeking care at 4 FP clinics in Atlanta. Before their provider visit, participants completed an HIV-risk screener. After, we asked participants about the HIV prevention counseling they received and how clinics could share information about PrEP...
January 31, 2019: Contraception
Melissa Natavio, Frank Z Stanczyk, Emilie A G Molins, Anita Nelson, William J Jusko
OBJECTIVE: To assess the pharmacokinetics (PK) of levonorgestrel after 1.5mg oral doses (LNG-EC) in women with normal, obese and extremely obese body mass index (BMI). STUDY DESIGN: The 1.5mg LNG dose was given to healthy, reproductive-age, ovulatory women with normal BMI (mean 22.0), obese (mean 34.4), and extremely obese (mean 46.6kg/m2 ) BMI. Total serum LNG was measured over 0 to 96h by radioimmunoassay while free and bioavailable LNG were calculated. The maximum concentration (Cmax), time to maximum concentration (Tmax), and area under the curve (AUC) of LNG were assessed...
January 28, 2019: Contraception
Katrina Mark, Rashida M Merchant, Kevin Hu
OBJECTIVE: To report pregnancy outcomes and potentially related complications among thirteen patients who had osmotic dilators placed for second-trimester dilation and evacuation followed by subsequent removal with the intention to continue their pregnancies. STUDY DESIGN: We reviewed billing and scheduling data between 2005 and 2017 to identify the total number of women seen for D&E and to identify the individuals who had dilators placed without a subsequent scheduled dilation and evacuation...
January 25, 2019: Contraception
Christina Buckel, Ragini Maddipati, Melody Goodman, Jeffrey F Peipert, Tessa Madden
OBJECTIVE: To compare the proportion of women receiving same-day long-acting reversible contraception (LARC) between two different models of contraceptive provision adapted from the Contraceptive CHOICE Project. STUDY DESIGN: We used a controlled time-trend study design to compare 502 women receiving structured contraceptive counseling in addition to usual care ("Enhanced Care") to 506 women receiving counseling plus healthcare provider education and cost support for LARC ("Complete CHOICE") at three federally qualified health centers...
January 24, 2019: Contraception
Babayemi O Olakunde, Nadia A Sam-Agudu, Tanviben Y Patel, Aaron T Hunt, Aurora M Buffington, Tara D Phebus, Ebube Onwasigwe, Echezona E Ezeanolue
OBJECTIVE: Uptake of permanent contraception among women remains low in sub-Saharan Africa compared to other regions. We aimed to synthesize available evidence on barriers to and facilitators of tubal ligation among women in sub-Saharan Africa. STUDY DESIGN: We reviewed literature on permanent contraception (tubal ligation) among women published between January 1, 2000 and October 30, 2017. We searched PubMed, Global health, EMBASE, Web of science, and Google scholar for quantitative, qualitative, and mixed methods studies which reported on barriers and/or facilitators to uptake of tubal ligation in sub-Saharan Africa...
January 24, 2019: Contraception
Junmei Zhang, Chenxiao Tang, Patrick J Oberly, Margaret B Minnigh, Sharon L Achilles, Samuel M Poloyac
OBJECTIVE: With the widespread use of sex-steroid hormones in contraceptives and hormone replacement therapy, there is an increasing need for reliable analytical methods. We report the development of a sensitive and robust UPLC-MS/MS method for quantitation of both endogenous and synthetic sex-steroid hormones in human serum. STUDY DESIGN: We developed and validated a UPLC-MS/MS method to quantify progestogens (etonogestrel, levonorgestrel, medroxyprogesterone acetate, norethindrone, progesterone) and estrogens (estradiol and ethinyl estradiol) with good accuracy, high sensitivity, and excellent robustness...
January 24, 2019: Contraception
Benjamin P Brown, Julie Chor, Luciana E Hebert, M Elizabeth Webb, Amy K Whitaker
OBJECTIVES: We explored how negative stories about long-acting reversible contraception (LARC) - defined as a firsthand negative experience with LARC shared directly with the study participant - were involved in participants' decisions about whether to use LARC following abortion, and how counseling affected the influence of negative LARC stories on contraceptive choices. STUDY DESIGN: We performed a multi-methods study, embedded within a trial examining the impact of a theory-based counseling intervention on LARC uptake post-abortion...
January 24, 2019: Contraception
Dandan Luo, Carolyn L Westhoff, Alison B Edelman, Melissa Natavio, Frank Z Stanczyk, William J Jusko
OBJECTIVES: To evaluate the pharmacokinetics (PK) of levonorgestrel-containing combined oral contraceptives (COCs) in obese women. STUDY DESIGN: We pooled and reanalyzed data from 89 women with different BMI categories from four clinical studies. The levonorgestrel (LNG) and ethinyl estradiol (EE) PK were analyzed utilizing a zero-order absorption (K0 ), two-compartment PK model to evaluate key PK parameters in relation to a range of weights, body mass index (BMI), and body surface area (BSA)...
January 23, 2019: Contraception
Sarah E Baum, Kari White, Kristine Hopkins, Joseph E Potter, Daniel Grossman
BACKGROUND: In 2013, Texas House Bill 2 (HB 2) placed restrictions on the use of medication abortion, which later were nullified with the 2016 FDA-approved mifepristone label. METHODS: Using data collected directly from Texas abortion facilities, we evaluated changes in the provision and use of medication abortion during three six-month time periods corresponding to the policy changes: before HB 2, after HB 2, and after the label change. RESULTS: Medication abortion constituted 28% of all abortions before HB 2, 10% after implementation of the restrictions, and 33% after the label change...
January 23, 2019: Contraception
Sonia Guleria, Louise T Thomsen, Christian Munk, Mari Nygård, Bo T Hansen, K Miriam Elfström, Lisen Arnheim-Dahlström, Kai-Li Liaw, Kirsten Frederiksen, Susanne K Kjær
OBJECTIVE: Women's contraceptive use at first sexual intercourse (FSI) may be associated with subsequent sexual behaviors. We examined associations between contraceptive methods used at FSI and subsequent number of lifetime partners, induced abortions and sexually transmitted infections (STIs). STUDY DESIGN: During 2011-2012, we collected questionnaire data from a random sample of women aged 18-45years from Denmark, Norway and Sweden. We used logistic regression and discrete-time proportional hazards models to estimate odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs), comparing different contraceptive methods used at FSI in the whole study sample and in women with FSI in 2001 or later (when emergency contraceptive pills (ECPs) were available without prescription)...
January 23, 2019: Contraception
Tara Shochet, Monica Dragoman, Jennifer Blum, Dina Abbas, Karmen Louie, Ingrida Platais, Tamar Tsereteli, Beverly Winikoff
OBJECTIVES: Current service delivery models for second-trimester medical abortion typically include routine inpatient admission and overnight stays. To assess the feasibility of a day-service model, we evaluated outpatient administration of abortion medications and analyzed the proportion of clients who could avoid an overnight stay. We also examined additional key elements of medical abortion care to evaluate the practicality of this model. STUDY DESIGN: We pooled data from 6 clinical studies of second-trimester medical abortion conducted by Gynuity over the past 10years...
January 9, 2019: Contraception
Somesh Kumar, Ashish Srivastava, Surendra Sharma, Vivek Yadav, Atul Mittal, Young-Mi Kim, Angela Nash-Mercado, Sijmen A Reijneveld, Bulbul Sood
OBJECTIVE: To evaluate outcomes of a national postpartum (within 48 h of delivery) copper intrauterine device placement (PPCuIUD) program in six "high-focus states" with high unmet family planning need in India. STUDY DESIGN: We identified high-volume district hospitals that provided PPCuIUD in six (Bihar, Jharkhand, Uttar Pradesh, Uttarakhand, Madhya Pradesh and Chhattisgarh) Indian states (two per state). Each selected hospital maintained a list of PPCuIUD acceptors with contact phone numbers...
December 18, 2018: Contraception
Renee Heffron, Sharon L Achilles, Laneta J Dorflinger, Janet P Hapgood, James Kiarie, Chelsea B Polis, Petrus S Steyn
Access to safe and effective contraceptive choices is a reproductive right and contributes tremendously to improvements in maternal and child health. Progestin-only injectables, particularly intramuscularly injected depot medroxyprogesterone acetate (DMPA-IM), have received increased attention given findings suggesting a potential association with increased HIV risk. For women at high risk of HIV, the World Health Organization's Medical eligibility criteria for contraceptive use (MEC) currently aggregate recommendations for all progestin-only injectables, including DMPA-IM, subcutaneously injected DMPA (DMPA-SC) and intramuscularly injected norethindrone/ norethisterone enanthate (NET-EN), except in the case of some drug interactions...
December 18, 2018: Contraception
Sunny Lu, Sally Rafie, Jeffrey Hamper, Rebecca Strauss, Lisa Kroon
OBJECTIVES: This study describes hormonal contraception services provided by pharmacists and characterizes patient populations utilizing the service at one supermarket-based pharmacy chain in California and Oregon. STUDY DESIGN: A descriptive study of 391 pharmacies in California and Oregon within a supermarket-based pharmacy chain providing hormonal contraception services and the patients who utilized those services in a 6.5-month period between August 2016 and February 2017...
December 15, 2018: Contraception
Chioma Ndubisi, Antoinette Danvers, Melanie A Gold, Lisa Morrow, Carolyn L Westhoff
OBJECTIVES: To assess pain-management using auricular acupuncture as an adjunct to ibuprofen and paracervical block during first trimester uterine aspiration, and to assess auricular acupuncture's effect on anxiety. STUDY DESIGN: This randomized, double-blinded, three-arm trial enrolled women undergoing uterine aspiration for spontaneous or induced abortion. Study participants were randomized 1:1:1 to receive auricular acupuncture, placebo, or usual care alone. Participants in all groups received ibuprofen and paracervical block (usual care)...
December 7, 2018: Contraception
Carolina Sales Vieira, Alison Pack, Kevin Roberts, Anne R Davis
OBJECTIVES: We explored levonorgestrel (LNG) concentrations, bleeding patterns and endometrial thickness in women with epilepsy (WWE) initiating an LNG-intrauterine device (IUD) co-administered with antiepileptic drugs (AEDs). STUDY DESIGN: This pilot study included 20 WWE ages 18 to 45 years with well-controlled seizures and stable AED regimens initiating a 52-mg LNG-IUD (20 mcg/d initial release). We collected blood and measured endometrial thickness before IUD placement and 21 days, 3 months and 6 months thereafter...
December 4, 2018: Contraception
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