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Direct Access to Emergency Contraception
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To the Editor: In their randomized controlled trial, Dr Raine and colleagues1 conclude that direct access to EC would not compromise contraceptive or sexual behaviors in women. We would like to raise the following points about their trial.
First, we are not aware of evidence that potentially harmful behavioral changes due to the perception of effectiveness and safety of EC would be detected within 6 months, so that a longer trial period might be necessary. Second, the proportion of pregnancies after the 6-month follow-up was high in all 3 study groups (between 7.1% and 8.0%) despite the relatively easy access to EC for each group, suggesting that providing easy access to EC may not reduce the pregnancy rate.
Third, it has been shown that self-reports of STIs are not reliable.2 Moreover, many STIs can be asymptomatic for long periods in both men and women, so that, for example, the short . . . [Full Text of this Article]
Miguel Ángel Martínez-González, MD, MPH, PhD;
Jokin de Irala, MD, MPH, PhD
jdeirala@unav.es
Department of Preventive Medicine
School of Medicine
University of Navarra
Navarra, Spain
Victoria Uroz, MD
School of Medicine
Universidad Complutense of Madrid
Madrid, Spain
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