Sales of emergency contraception are estimated to increase by about 10% in the US in the week after the New Year holiday, suggesting that this period is associated with increased risks of unprotected sex compared to other holidays, a study published in the Christmas issue of The BMJ.
Other holidays such as Valentine’s Day and Independence Day were also associated with increased sales, but to a lesser extent.
While this year-over-year increase in sales may seem humorous, the researchers point out that just as many US states have increased abortion restrictions “is indicative of an unmet need for contraception that warrants further attention.”
New Year’s Eve celebrations are associated with increased sexual activity, which is less likely to be protected due to increased alcohol intake. New Year’s Eve is also associated with higher rates of sexual assault and limited access to other forms of contraception due to the limited hours of operation of clinics, medical offices and stores.
To assess sales of emergency contraception after the New Year’s holiday, researchers analyzed retail scan data for levonorgestrel, a drug that has been available without age restrictions since 2013.
Despite its common nickname as the “morning-after pill,” levonorgestrel is effective when taken within 96, and possibly 120, hours after unprotected sex, although it is more likely to work the sooner it is taken. This makes timely access critical.
They focused on sales in the week following New Year’s Eve and New Year’s from 2016 to 2022 at US retail stores, including grocery stores, drugstores, mass merchandisers, club stores, dollar stores and military stores.
To account for possible changes in the population at risk of pregnancy, weekly sales were divided by the size of the female population aged 15 to 44.
Overall, sales of levonorgestrel rose by 0.63 units per 1,000 women aged 15 to 44 in the week after New Year’s Eve. Based on population estimates in 2022, this equated to nearly 41,000 additional pills sold that year.
The researchers also looked at other holidays that may be associated with higher unprotected sex, such as Valentine’s Day, Independence Day and St. Patrick’s Day.
Valentine’s Day was associated with a sales increase about half the New Year’s increase: 0.31 units per 1,000 women. US Independence Day was associated with a 0.20 increase in sales and St. Patrick’s Day with a 0.14 increase.
Holidays such as Mother’s Day, Father’s Day and Easter were not associated with increased sales.
The researchers point out some limitations. For example, sales of emergency contraception are not synonymous with use, and the data do not include emergency contraception obtained through medical clinics, independent pharmacies, and online sales. Differences in how and which holidays are celebrated and how reproductive health care is accessed may also limit the generalizability of the findings to other settings, they add.
However, they say their results suggest that the nature of some celebrations may make them important public health targets and suggest that “targeting behavioral risks, prevention strategies to mitigate sexual violence, and improving access to contraception during the holidays may limit the risks associated with unprotected vaginal intercourse.”
“More than ever, emergency contraception is a critical option for people in the US, particularly those who live in areas with abortion bans or severe restrictions,” they write.
“Future work will explore how other dynamics at play in the US context, including state abortion restrictions, affect emergency contraceptive purchasing behavior and implicate potential public health interventions to provide contraceptive care to those who need it most.”
Source:
Journal Reference:
Wagner, B., & Cleland, K. (2023). Retail demand for emergency contraception in the United States after the New Year holiday: a time series study. BMJ. doi.org/10.1136/bmj-2023-077437.
