Before 1998, students who visited school-based clinics received vouchers they could redeem for free birth control at community clinics. Only 41 percent of students received all of the contraceptives they requested, however, suggesting that many students were not using the vouchers.
To remedy this, Minneapolis school-based clinics began distributing birth control directly to students in May 1998.
By 2000, 99 percent of the students received all of the contraceptives they requested, according to Abbey Sidebottom, M.P.H., of the Minneapolis Department of Health and Family Support and colleagues.
"Although we were unable to examine whether students used the contraceptives they obtained, there is cause for optimism in light of evidence that improving access to contraception increases actual rates of use among those who are already sexually active," Sidebottom and colleagues say.
Under the voucher system, only 21 percent of students received all the condoms and 11 percent received all the oral contraceptives they requested. All condom and oral contraceptive requests were fulfilled under the direct distribution system in 2000.
The percentage of students requesting contraceptives -- 11 percent -- remained steady between the two years.
"Previous research with adolescents has indicated that making contraceptives accessible does not increase sexual activity among adolescents who weren't previously sexually active," Sidebottom says. "The fact that we did not see an increase in demand for contraceptives among the student population at these schools seems to agree with these findings."
A recent national survey of high school clinics found that 18 percent directly dispense birth control pills and 28 percent dispense condoms.
"Our findings suggest that school-based clinics could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system," Sidebottom and colleagues say.
BY BECKY HAM, SCIENCE WRITER
HEALTH BEHAVIOR NEWS SERVICE
The study was supported by the Minneapolis Department of Health and Family Support.
FOR MORE INFORMATION
Health Behavior News Service: 202-387-2829 or http://www.
Interviews: Contact Abbey Sidebottom at 612-673-3931.
American Journal of Public Health: 202-777-2511 or http://www.ajph.org.