There were 99 female participants (76.2%) and 31 male participants (23.8%). The mean age of participants was 18.3 years old. The majority (65.3%) of respondents were aged 18 – 23 years old and about one third (34.7%) were aged 13 – 17 years old. A majority of respondents were either in high school (38.5%) or college (44.3%). Demographic results revealed 31.3% Black/African-American, 30.5% Latino/Hispanic, 17.6% White, 3.0% Asian, and 14.5% Other. A majority of respondents had health insurance, either private (25.6%) or public (40.2%).
The majority (80%) of participants were sexually active. The majority (82.8%) reported having partners of the opposite sex, 14.1% reported having with partners of the same sex, and 3.0% reported having both partners of the same and opposite sex. Most (69.5%) participants stated they or their partner were currently using a contraceptive method. Of those using birth control, 71% used condoms, 38% used oral contraception pills (OCP), while only 2.6% used IUDs. Approximately one third (36.4%) of total respondents reported a history of EC use by them or their partner(s). The majority (90.5%) of total respondents reported no history of STIs and 90.4% reported no history of pregnancies in themselves or their partner(s).
Most of the participants surveyed were aware of contraceptive methods. Survey results indicated that 100% were aware of male condoms; 89.9% were aware of female condoms; 92.2% were aware of OCPs; 66.7% were aware of IUDs; 63.3% were aware of hormonal implants; 76.2% were aware of injectable contraceptive hormones; 72.1% were aware of hormonal vaginal rings; and 64.8% were aware of hormonal contraceptive patches. Of those who responded that they had heard of the IUD, 84.9% were females and only 15.1% were males [Table 1]. Of the participants who responded that they had heard of the IUD, 90.7% were sexually active, 72.1% stated that they themselves or their partner(s) were using a form of contraception, and 49.4% stated they or their partner(s) had used EC in the past (p<0.001) [Table 1].
Table 1: Demographics by Awareness of IUDs
|
Have you heard of the IUD?
|
P value
|
Yes
(n = 86)
|
No
(n = 43)
|
Gender
Female
Male
|
73 (84.9)
13 (15.1)
|
25 (58.1)
18 (41.8)
|
0.002
|
Sexual History
Sexually Active
Never Sexually Active
|
78 (90.7)
8 (9.3)
|
26 (60.5)
17 (39.5)
|
< 0.001
|
Birth Control Use (self or partner)
Yes
No
|
62 (72.1)
24 (27.9)
|
13 (30.2)
30 (60.8)
|
< 0.001
|
EC Use (self or partner)
Yes
No
|
42 (49.4)
43 (50.6)
|
5 (11.9)
37 (88.1)
|
< 0.001
|
The results reported are frequency counts with percentages in parenthesis.
Almost half (49.2%) of participants who responded that they were satisfied with their method of birth control had used EC in the past (p<0.001) [Table 2]. Of those with a history of EC use by themselves or their partner(s), 83.0% reported that they or their partner(s) were using a method of birth control (p<0.001) [Table 3]. Only 17.8% who reported a history of EC use knew the copper IUD could be used for EC (p<0.001) [Table 3].
Table 2: Satisfaction with Birth Control and Emergency Contraception (EC) Use
|
Satisfaction with Birth Control
|
P value
|
Yes
(n = 59)
|
No
(n = 8)
|
I am not using birth control
(n = 61)
|
History of EC Use (self or partner)
Yes
No
|
29 (49.2)
30 (50.8)
|
6 (75.0)
2 (25.0)
|
11 (18.0)
50 (82.0)
|
< 0.001
|
The results reported are frequency counts with percentages in parenthesis.
Table 3: History of Emergency Contraception (EC) Use
|
History of EC Use (self or partner)
|
P value
|
Yes
(n = 47)
|
No
(n = 82)
|
Birth Control Use (self or partner)
Yes
No
|
39 (83.0)
8 (17.0)
|
36 (43.9)
46 (56.1)
|
< 0.001
|
Knowledge that Copper IUD can be used as EC
Yes
No
|
8 (17.8)
37 (82.1)
|
8 (10.0)
72 (90.0)
|
< 0.001
|
The results reported are frequency counts with percentages in parenthesis.
The awareness of the IUD was also specifically assessed by gender, sexual history, birth control use, and EC use. Of those who had heard of the IUD, 90.7% reported history of sexual activity and 49.4% reported history of EC use by them or their partner(s) (p<0.001) [Table 2]. Despite having heard of IUDs, both male and female participants lacked knowledge regarding the utility of the IUD, whether or not they were sexually active. [Table 4] Only 14.1% of those who had heard of the IUD knew that it could be used as EC (p<0.001) [Table 4].
Table 4: Awareness vs. Knowledge Assessment of Utility of IUDs
Have you heard of the intrauterine device (IUD)?
|
P Value
|
Yes
(n=86)
|
No
(n=40)
|
The copper IUD is inserted into the uterus.
|
51 (59.3)
3 (3.5)
32 (37.2)
|
6 (15.0)
0 (0)
34 (85.0)
|
<0.001
|
True
|
False
|
I don’t know.
|
Insertion of the copper IUD can cause cramping.
|
35 (41.2)
4 (4.7)
46 (54.1)
|
3 (7.5)
1 (2.5)
36 (90.0)
|
<0.001
|
True
|
False
|
I don’t know.
|
The copper IUD prevents pregnancy when used appropriately.
|
62 (72.9)
2 (2.4)
21 (24.7)
|
6 (15.0)
2 (5.0)
32 (80.0)
|
<0.001
|
True
|
False
|
I don’t know.
|
The copper IUD does not protect against sexually transmitted diseases.
|
52 (61.2)
5 (5.9)
28 (32.9)
|
5 (12.5)
2 (5.0)
33 (82.5)
|
<0.001
|
True
|
False
|
I don’t know.
|
Irregular Bleeding is a side effect of the copper IUD
|
37 (44.1)
2 (2.4)
45 (53.5)
|
3 (7.5)
2 (5.0)
35 (87.5)
|
<0.001
|
True
|
False
|
I don’t know.
|
The copper IUD can be used as a method of EC.
|
12 (14.1)
35 (41.2)
38 (44.7)
|
4 (10.0)
2 (5.0)
34 (85.0)
|
<0.001
|
True
|
False
|
I don’t know.
|
You can use the copper IUD even if you’ve never had a baby.
|
50 (59.5)
3 (3.6)
31 (36.9)
|
3 (7.5)
1 (2.5)
36 (90.0)
|
<0.001
|
True
|
False
|
I don’t know.
|
The copper IUD does not require daily reminders.
|
52 (61.2)
4 (4.7)
29 (34.1)
|
5 (12.5)
0 (0)
35 (87.5)
|
<0.001
|
True
|
False
|
I don’t know.
|
The results reported are frequency counts with percentages in parenthesis.
Participants were provided with an educational piece at the end of the survey, which stated: “The Intrauterine Device (IUD) is a small T-shaped device about 1 inch long. It is a very effective method of birth control that your health care provider inserts into the uterus. Non-hormonal (copper) and hormonal versions are available. The non-hormonal or copper version can be left in place for up to 10 years. The hormonal version can be left in place for up to 3 to 5 years.” They were subsequently asked if they would use and/or recommend the IUD as a form of birth control. Approximately half of the participants remained neutral despite receiving the education and some provided feedback on their decisions. Some participants listed common misconceptions as their reasons against choosing the IUD in their comment section of the survey. Some participants commented that they still did not have enough knowledge regarding the IUD in general and expressed reluctance to use it or recommend to others.
Participants were also provided with information regarding the copper IUD’s function as form of EC. The statement “Studies have shown that the copper IUD is the most effective form of emergency contraception” was provided to the participants. They were subsequently asked if they would use or recommend the copper IUD as a form of EC. Almost half of the participants remained neutral despite receiving this information and some provided feedback on their decisions. The provided feedback did reveal that some participants did feel like the copper IUD would be a good option for EC after reading the information about the efficacy of the copper IUD.