Will emergency contraception make women behave differently? (UPDATED)

One of the common knocks against emergency contraception (and against the HPV vaccine, for that matter), is that it will lead to fewer women practicing safe sex. In other words, remove the “danger” from sex, and people won’t be afraid of it.

I will ignore the assumptions inherent in such an argument for the moment, and just focus on the hypothesis. Will EC do that to women? As we’d say on Healthcare Triage, “to the research!”

Objective: We studied whether increased emergency contraception availability for women over age 18 was associated with a higher probability of risky sexual practices.

Data: A total of 34,030 individual/year observations on 3,786 women aged 18 and older were extracted from the National Longitudinal Survey of Youth, 1997 from October 1999 through November 2009.

Study Design: We modeled three binary outcome variables: any sexual activity; sexual activity with more than one partner; and any sex without a condom for women with multiple partners for women in states with state-level policy changes (prior to the 2006 FDA ruling) and for women in states subject to only the national policy change both jointly and separately.

Researchers used the National Longitudinal Survey of Youth to look at women age 18 and older. The outcomes of interest included sexual activity, sexual activity with more than one partner, and sex without a condom and multiple partners. They measured these outcomes both before and after state-level policy changes that affected emergency contraception access. In the study period, eight states increased access by allowing it to be sold behind the counter (without a prescription) before 2006; in that year, national policy allowed it to be sold that way anywhere.

When looking at those states only, women who had easier access to emergency contraception had no change in the probability of sexual activity or having more than one partner. However, women seemed to be having more unprotected sex in those states after emergency contraception was more easily accessed.

But, in the states that were affected only by the national policy change in 2006, more accessible emergency contraception was associated with a decrease in sexual activity and a decrease in the probability of having more than one sexual partner. And it wasn’t associated with any change in unprotected sex. So nationally, I’d be curious to know how someone could look at this as an unwelcome outcome.


(UPDATE: yes, I changed the title cause I decided this was better than snarky. And I fixed a paragraph where I made some mistakes.

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