More than a decade after the Food and Drug Administration approved the use of mifepristone in combination with misoprostol for medication abortion, population-level data documenting patterns of use and availability are scarce. Cristina Yunzal-Butler and colleagues take a step toward filling this gap by analyzing New York City surveillance data to examine trends in medication abortion, its availability and who chooses it. They report in this issue of Perspectives on Sexual and Reproductive Health (see article) that the proportion of early abortions that were medication procedures nearly tripled between 2001 and 2008, that these abortions were provided predominantly in hospitals and clinics, but that medication procedures were not available at half of hospitals and one-third of clinics that provided early abortions. In addition, for reasons that remain to be explored, abortion patients who were white or had a postsecondary education had an elevated likelihood of having medication, rather than surgical, procedures. The authors recommend that future investigations examine both factors affecting women’s choice of type of abortion and provider-side barriers to offering medication procedures.

Also in This Issue

• Which reversible contraceptive physicians recommend for their patients appears to vary by doctors’ own background and practice-related characteristics, according to findings reported by Christine Dehlendorf and coauthors (see article). The researchers showed each physician in a sample of contraceptive care providers one of 18 videos portraying an actress seeking contraceptive advice; the script was standardized across "patients," who varied only in certain background characteristics. Several striking differences emerged when physicians were asked how likely they were to recommend each of six reversible methods to this woman. For example, doctors older than 35 were significantly less likely than their younger counterparts to say that they would recommend an IUD, and private practitioners were more likely than academic physicians to say that they would recommend the pill. Women’s characteristics had little relationship to the method recommendation. Dehlendorf and colleagues point to the need to understand these differences among providers as a direction for further study.

• Teenage mothers participating in a qualitative study in North Carolina reported that their contraceptive use improved after they gave birth, Ellen K. Wilson and coinvestigators report (see article). Several reasons apparently help to explain this change: For some teenagers, pregnancy was a "wake-up call" to their vulnerability to risk; for others, increased exposure to the health care system during the prenatal and postpartum periods gave them greater access to contraceptive information and services. Still others related that after giving birth, they were able to talk to their parents about sex more openly than they could before. Nonetheless, a number of young mothers were dissatisfied with the method they chose after delivery and switched methods. "Adolescent mothers need support to start and continue contraceptive use," Wilson and her team write. Such support "will require concerted efforts from health care providers, social service organizations and parents."

• A sample of sexually active black and Puerto Rican young adults living in urban areas with relatively high STD and HIV rates reported widespread acceptance of STD and HIV testing in a study by Marion W. Carter and colleagues (see article). The vast majority of participants had had at least one STD test and at least one HIV test, and most had been tested multiple times. Although these young adults generally considered their risk of infection low, many reported undergoing testing for peace of mind or as a matter of routine. Levels of partner communication about testing were high, particularly within serious relationships. While the results are largely encouraging, they also suggest that some young adults view testing as a preventive strategy, and that "important areas for improvement [remain] in this population’s openness about STD risk and testing."

• In a randomized clinical trial described by Vincent Guilamo-Ramos and his team (see article), a new parent-based intervention was about as effective as a leading adolescent-only intervention at delaying Latino and black youths’ sexual initiation. Combining the two, however, did not improve the effectiveness of the parent-based program. Although the researchers comment that features of the study design may have contributed to this finding, they also say that "it may be more practical to use only one or the other intervention." And while they contend that "evidence-based sex education programs that directly target youth should continue to be a priority," they urge further research to explore how to maximize the effectiveness of parent-based interventions.

• Jocelyn T. Warren and colleagues add two dimensions to the study of effective contraceptive use among Latinos by interviewing a rural sample and including measures that take into account the context of relationships (see article). Among the notable findings are that confidence in one’s ability to use a contraceptive method with a primary partner was associated with increased odds of using an effective female method, rather than no method, and that participation in sexual decision making was positively associated with use of male condoms, rather than use of a female method or of no method. Interventions to prevent unintended pregnancy among rural Latinos, the authors conclude, may benefit by addressing "the potential role of partner and relationship characteristics in the sexual risk and protective behaviors of women, men and couples."

—The Editors