Preliminary report of sexual assaults at Ekiti Sexual Assault Referral Centre, Ado-Ekiti, Southwest, Nigeria (Moremi Clinic)

There has been a surge in the incidence and severity of sexual assaults globally with the insurgence of COVID-19 owing to lockdown restrictions. Ekiti Sexual Assault Referral Centre, Ado-Ekiti also known as Moremi Clinic was established in June 2020 as a multisectoral response centre to this surge. Seventy-four survivors accessed medical services from June 2020 to May 2021. Adolescents made up 54.1% while the median age was 14.5 years. Only seven survivors were seen within 24 h of the event and around a quarter had follow-up visits. A quarter of survivors reported repeat episodes of sexual assault. Complications documented were sexually transmitted infections (13.5%), depression (4.1%) and posttraumatic stress disorder (5.4%). There was a failure of contraception in 4.5% of survivors who had taken emergency contraceptive pills. For improvements in quality of care, strategies to ensure early presentation and encourage follow-up visits must be introduced.

Knowledge and Attitude Toward Emergency Contraceptive Pills Among First-Year Undergraduate Students in Southern Thailand

Background: The objective of this study was to investigation of the knowledge and attitude towards emergency contraceptive pills (ECPs) among first-year undergraduate students in a university in Thailand.Methods: This cross-sectional survey study was performed using the developed questionnaires that was validated by four experts. The questionnaires were distributed to all the first-year students in the university via an online platform. The characteristic data were descriptively analyzed and the knowledge data were analyzed using Chi-square test, Mann-Whitney U test and one-way ANOVA.Results: A total of 335 students who responded to the questionnaires and met the eligible criteria for the study was analyzed. The mean knowledge score of all respondents was 7.76±0.15 out of 15. The most correct-answered questions were the questions relating to efficacy and safety of ECPs in pregnant women (78.5% and 72.2% corrected, respectively). On the contrary, the least correct-answered questions were about the ECP regimens and using ECPs instead of combined oral contraception (COC) (30.4% and 34.9%, respectively). In addition, the results indicated that experience in using ECPs and in ECP education were significant factors in high scores of knowledge. Moreover, most respondents trusted and would like to receive the information on ECPs from health professionals in hospitals, academic institutions, or pharmacies.Discussion: The average knowledge of ECPs of first-year students in a university in Thailand was at a moderate level. More knowledge about the regimens of the drug and using ECPs instead of COC should be advised to students, particularly at the university or pharmacies, and should be done by healthcare staff.

Kontrasepsi Darurat dan Permasalahannya

Emergency contraception is a contraceptive method that can prevent pregnancy if used immediately following unprotected sex. The use of emergency contraception could reduce the rate of unwanted pregnancy by up to 50%. There are two emergency contraceptive methods, including the emergency contraceptive pill and copper intrauterine device (IUD). Emergency contraceptive pills should be taken immediately following unprotected sex and are most effective when taken within 24 hours. IUD as an emergency contraceptive can be applied five days after unprotected sex, and it does not cause abortion. There is no absolute contraindication for emergency contraception except for known pregnancy, and simply because it is ineffective. The efficacy of emergency contraception can be defined by the proportion of women who become pregnant after using this method and the total pregnancy observed after using the method divided by the estimated number of pregnancies that would occur without using the method.Keywords: emergency contraception; sexual intercourse; pregnancy Abstrak: Kontrasepsi darurat dapat mencegah kehamilan bila digunakan segera setelah senggama. Penggunaan kontrasepsi darurat dapat menurunkan angka kehamilan yang tidak diinginkan hingga 50%. Terdapat dua metode kontrasepsi darurat, yaitu pil kontrasepsi darurat dan alat kontrasepsi dalam rahim (AKDR) yang menggunakan tembaga. Pil kontrasepsi darurat harus diberikan sesegera mungkin setelah senggama tidak terlindungi, dan paling efektif bila diberikan dalam waktu 24 jam. AKDR sebagai kontrasepsi darurat dapat dipasang hingga lima hari pasca senggama tidak terlindungi. Kontrasepsi darurat terutama bekerja dengan mencegah fertilisasi, dan tidak menggugurkan kehamilan. Tidak ada kontraindikasi absolut untuk penggunaan kontrasepsi darurat kecuali kehamilan yang diketahui, dan ini hanya karena tidak efektif. Efektivitas kontrasepsi darurat dapat didefinisikan dari proporsi wanita menjadi hamil setelah menggunakan metode ini, dan jumlah kehamilan yang diamati setelah penggunaan dibagi dengan perkiraan jumlah kehamilan yang akan terjadi tanpa penggunaan.Kata kunci: kontrasepsi darurat; senggama; kehamilan

Emergency Contraceptives: Knowledge, Attitude and Prescription Practice of Primary Healthcare workers in Sokoto Metropolis, Northwest Nigeria.

Background: Emergency contraception refers to methods of contraception that can be used to prevent pregnancy after sexual intercourse. About thirty percent of all pregnancies, and 61% of all unintended pregnancies, ended in an induced abortion in Nigeria, and many women with unwanted pregnancies decide to end them by abortion. Healthcare providers' knowledge and attitude towards emergency contraception is very important for dissemination of awareness, consumer acceptance and use of contraceptives, as health care workers interact with large numbers of women and are reliable sources of information. This study aimed to assess healthcare workers' emergency contraception knowledge, attitude and prescription practice. Materials and Methods: The study was a cross-sectional study. Healthcare workers providing services in Primary Health care facilities of Sokoto metropolis were studied. Using formula for sample size estimation for crosssectional study, a total of 419 respondents were recruited into the study using systematic sampling technique. The instrument of data collection was a structured interviewer administered questionnaire and data was collected by means of Open Data Kit for android App and analysed using IBM SPSS statistical software package version 23. Univariate and bivariate analysis were conducted; level of significance was set at 5%. Results: Few (39.9%) respondents knew that Intra uterine contraceptive devices can be used for emergency contraception, only 15.4% knew how emergency contraceptives work. Most (75.4%) believed that emergency contraceptives should be available only on prescription; and 30.5% felt that emergency contraceptive pills promote irresponsible behaviour. More than half of the respondents (56.5%) had prescribed within the last one month, 48.7% of them prescribed less than 5 times within the month. Only 27(8.0%) have ever prescribed emergency contraceptive pills in advance of need. Conclusion: The study respondents had good knowledge of emergency contraceptives, albeit, with some misconceptions, they also demonstrated good attitude, however, the prescription practice was fair.

Choosing Plan B Over Plan A: Risk Compensation Theory and Contraceptive Choice in India

Can women's contraceptive method choice be better understood through risk compensation theory? This theory implies that people act with greater care when the perceived risk of an activity is higher and with less care when it is lower. We examine how increased over-the-counter access to emergency contraceptive pills (ECPs) accompanied by marketing campaigns in India affected women's contraceptive method choices and incidence of sexually transmitted infections (STIs). Although ECPs substantially reduce the risk of pregnancy, they are less effective than other contraceptive methods and do not reduce the risk of STIs. We test whether an exogenous policy change that increased access to ECPs leads people to substitute away from other methods of contraception, such as condoms, thereby increasing the risk of both unintended pregnancy and STIs. We find evidence for risk compensation in terms of reduced use of condoms but not for increases in rates of STIs.