Is sex at weekends more risky: and analysis of visits for emergency
contraception to community clinics
P. O’Brien, C. Smith, Codrington
Westside Contraceptive Services, London, UK
Objectives: The need for emergency contraception is greatest at
weekends, at times when access is most limited. This study examines the use of
emergency contraception in an inner city community service by day of week to
assess if the weekend deficit in provision is compensated by increased use on
Mondays.
Design and methods: A database of contraception clinic visits was
examined for prescriptions of emergency hormonal contraception by day of week.
Assuming equal need for each day of the week, we estimated the weekend
requirement for Saturday to Monday by tripling the Wednesday use, which we
considered a conservative estimate.
Results: 254,376 visits were recorded over 5 years, or which 19,393
were for emergency hormonal contraception. The proportions of all visits on
Monday to Saturday were 22%, 22%, 24%, 17%, 14% and 2% respectively. The
corresponding proportions of visits for EHC were 30%, 21%, 18%, 13%, 13% and 5%,
indicating a greater demand for EHS on Mondays and Saturdays. The average annual
Wednesday use of EHC was 689, suggesting a conservative weekend requirement of
2,066. The annual weekend provision (Saturday to Monday) was 1,357, suggesting
an annual weekend deficit of 709. Clients in age groups 12–15 and 16–19 had
disproportionately fewer visits on Mondays and Saturdays (Mondays 28% and 27%,
Saturdays 4% and 3%). Asian/Asian British and Black/Black British clients also
made proportionately fewer visits for EHC on the same days (Mondays 25% and 28%,
Saturdays 2% and 4%). The proportion of visits on Mondays and Saturdays for EHC
fell slightly between 1997 and 2000, and remained stable since.
Conclusions: This analysis suggests that there is a significant
shortfall in use of EHC at weekends, equivalent to one day’s use using a
conservative assumption that daily needs at the weekend are similar to midweek.
It is unlikely that other sources for EHC compensate for this. If the recent
evidence suggesting the lack of a trend in efficacy for EHC with increasing time
to treatment is confirmed, expanded provision on Mondays may compensate for the
weekend deficit. The provision should be targeted at younger and minority ethnic
groups.
