Knowledge and perceptions of emergency contraceptive pills among a college-age population: a qualitative approach

Abstract

Results from focus-group discussions with a population of university students who have convenient access to emergency contraceptive pills show that basic awareness about this method is high, although specific knowledge on appropriate use, such as the time limit for use, the level of effectiveness and the possible side effects, is lacking. Approval of the method is widespread among both female and male students, although students did voice anxieties about irresponsible use and the lack of protection against the human immunodeficiency virus and other sexually transmitted diseases. Many of their concerns stem from incomplete information about how the regimen works. Students noted how rarely emergency contraceptive pills are discussed, and were curious to know more. They asked for routine education on the method, as well as more general discussion.

PIP: Knowledge and attitudes about emergency contraception were assessed in focus group discussions conducted at New Jersey's Princeton University, where "morning-after" pills have been routinely available through the student health center for over 15 years. A total of 11 group discussions, involving 94 male and female graduate and undergraduate students and 6 health center staff, were held. As hypothesized, higher levels of knowledge about emergency contraception were associated with more favorable attitudes about its use. Common themes emerging from these discussions included concern that this method--which confers no protection against sexually transmitted diseases--would be used routinely in lieu of a barrier method, the negative impact of campus alcohol abuse on sexual responsibility, the potential for men to use the availability of postcoital contraception to pressure women into unprotected sex, alleviation of the psychological and financial consequences of abortion or unwanted pregnancy, whether this method falls into the category of contraception or abortion, embarrassment associated with acknowledging to a health provider than unprotected sex has occurred, the risks and benefits of routine dispensing of emergency contraceptive pills with barrier methods, and the need for ongoing informational campaigns and peer-led discussions. Although both awareness and approval of emergency contraception were high, students were unsure about the time limit for use, the level of effectiveness, the mechanism of action, and potential side effects.