With colleagues at the University of Texas at Austin and El Paso, we are collaborating on an NIH-funded project collecting data from women who cross the border from the US to Mexico to obtain oral contraceptives (OCs) over the counter (OTC). During the first stage, we completed a study evaluating whether women can self-screen for contraindications to OC use and found that younger women, more educated women, and Spanish-speakers were significantly more likely to correctly self-screen. We recently published a related analysis of a large health survey in Mexico and found that women who obtained OCs OTC from a pharmacy were no more likely to be contraindicated for use than those who obtained OCs from a clinic, suggesting that pharmacy-goers were adequately self-screening for contraindications.
For the next phase of the project, we are recruiting two cohorts of OC users in El Paso: those who obtain their pills in Mexico OTC and those who obtain them in clinics in the US. We will follow women for nine months to assess pill efficacy, continuation, and satisfaction and women’s motivation for obtaining pills where they do. In addition, we received funding from the Center for Border Health Research for an add-on study, in which we will assess the rate of hypertension among this population, as well as women’s awareness about the causes, prevention, and treatment of hypertension in relation to OC use. These projects will continue through 2010, and the results are expected to have important implications for contraception policies in the US.