Contraception in Person-Contraception Online (CiP-CO) cohort study. Issue 2 (27th August 2021)

• Record Type: Journal Article
• Authors: Rezel-Potts, Emma; Palmer, Melissa J; Free, Caroline J; McCulloch, Hannah; Baraitser, Paula
• Is Part Of: BMJ sexual & reproductive health. Volume 48:Issue 2(2022)
• Page Start: 93
• Page End: 102
• Publication Date: 2021-08-27
• Subjects: contraception behavior -- contraceptives -- oral -- epidemiology -- Reproductive Health Services -- surveys and questionnaires; Reproductive health -- Periodicals; Sexual health -- Periodicals; Birth control -- Periodicals; Contraception -- Periodicals; 613.905
• DOI: 10.1136/bmjsrh-2021-201168
• Languages: English
• ISSNs: 2515-1991

Abstract

Abstract : Background: Online contraception services increasingly provide information, clinical assessment and home-delivered oral contraceptives (OCs). Evidence is lacking on the effects of online contraceptive service use on short-term contraceptive continuation. Methods: Cohort study comparing contraceptive continuation between new users of a free-to-access online OC service in South East London with those from other, face-to-face services in the same area. Online questionnaires collected data on participants' sociodemographic characteristics, motivations for OC access, service ratings, OC knowledge and contraceptive use. Contraceptive use in the 4-month study period was measured using health service records. Unadjusted and multivariable logistic regression models compared outcomes between the online service group and those using other services. Results: Online service-users (n=138) were more likely to experience short-term continuation of OCs compared with participants using other services (n=98) after adjusting for sociodemographic and other characteristics (adjusted OR 2.94, 95% CI 1.52 to 5.70). Online service-users rated their service more highly (mean 25.22, SD 3.77) than the other services group (mean 22.70, SD 4.35; p<0.001), valuing convenience and speed of access. Among progestogen-only pill users, knowledge scores were higher for the online group (mean 4.83, SD 1.90) than the other services group (mean 3.87, SD 1.73; p=0.007). Among combined oral contraceptive users, knowledge scores were similar between groups. Conclusions: Free-to-access, online contraception has the potential to improve short-term continuation of OCs. Further research using a larger study population and analysis of longer-term outcomes are required to understand the impact of online services on unintended pregnancy.