Free emergency birth control associated with increased STIs

**Girma S. J Health Economics. 2011;doi: 10.1016/j.jhealeco.2010.12.004.**

Issue: March 2011

Free access to the “morning-after pill” has not reduced teenage pregnancy and may be associated with an increase in sexually transmitted infections.

Researchers at the University of Nottingham in the United Kingdom assessed health data from local authorities to measure the effectiveness of government-sponsored initiatives offering teenagers free emergency birth control (EBC) at pharmacies.

To measure the sexually transmitted infection (STI) rate, data were pooled from genitourinary medicine clinics on pediatric STI diagnoses in the younger than 18 years and younger than 16 years age groups. This was compared with a control group of women older than 24 years without access to EBC.

Overall, they found that areas with a pharmacy that offered free EBC observed an average 5% increase in STIs among teens younger than 18 years. In those younger than 16 years, the STI rate increased by 12%.

Although STI rates for teens and older women increased consistently during the study period, teenage STI rates increased faster as EBC programs were introduced. Further, they found that EBC initiatives may even be associated with a small increase in the rate of teen pregnancies.

“There are at least two possible explanations for these null results,” the researchers wrote. “The first is that increased access to EBC for adolescents does, in fact, result in reductions in teenage pregnancy, but that the effects are too small for the statistical tests used to reveal them. A second explanation is that, as might be predicted by standard microeconomic theory, increased access to EBC induces at least some adolescents to increase their level of risk-taking sexual behavior and that the reduction in pregnancies from greater use of EBC is being countered by additional pregnancies resulting from this behavior change.”

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