Although the availability of emergency contraceptives like Plan B has made some people more likely to engage in high-risk sexual behaviors, student health officials and Duke Educational Leaders in Sexual Health say most students who use Plan B do so responsibly.
"The idea of using Plan B just so you don't have to have safe sex is definitely out there, but I don't know how prevalent it is," said Jean Hanson, assistant director of student health. "Every year we may have one person that comes in several times for it, and with that person we wonder what's really going on. But generally speaking, my perception is that people are using it very appropriately."
Senior Sourave Sengupta, who has worked to educate students about sexual health since he was a freshman, noted that the same seems to be true of college students nationwide. He said studies at colleges have shown that less than 5 percent of women who received a prescription for Plan B returned for another prescription. "It's not like we're seeing a huge run on the product as birth control," he said.
Plan B was recently approved by the United States Food and Drug Administration, and may soon be available without a prescription. If taken within 72 hours of unprotected intercourse, it can reduce the risk of pregnancy by 89 percent.
Senior Jenna Williams-Bader, peer educator president and a member of DELISH, echoed the sentiment that Plan B is being used responsibly at Duke.
"For most people who have used it, I think it was just a one-time mistake they wanted to take care of, like a broken condom," she said. "They didn't say beforehand, 'Well, I can be careless because I can go take Plan B tomorrow.'"
She acknowleged, however, that there may be a few students who use Plan B regularly as a form of contraception, but said "these are people who are going to be engaging in dangerous activities anyway, whether or not Plan B is around."
Although Plan B has been available at the Student Health Center since November 2000, Williams-Bader said most students do not have enough information about the product to make use of it.
Hanson reported that the pharmacy dispensed 162 Plan Bs from March 1, 2003, to February 29, 2004. This figure does not include those dispensed by nurses on weekends or evenings, but the number of additional prescriptions is thought to be small.
"Plan B is not a big pharmaceutical product, so it's not well-publicized because it's not produced by a huge for-profit company," said senior Sourav Sengupta. "There's a lot of fear about possible side effects, so if anything, there's a question of, 'Do I really want to use this at all?' rather than a sense that people are overusing it."
Sengupta said that, on a nationwide level, many people who seek abortions say they did not know about their emergency contraception options or were too scared to use them when they could.
Student health's confidence that students do not misuse emergency contraceptives is reflected in a confidence that, even were Plan B offered as an over-the-counter medication, Duke students would not interpret its increased availability as a license to throw caution to the wind.
"At a place like Duke, students can already get ahold of Plan B within 24 hours at any point," said Rebecca Griesse, a health education specialist in student health, noting that students who might abuse the over-the-counter designation could already have done so under the University's system. "Most students seem to be using Plan B responsibly already, and I don't think that would change if it were over-the-counter."
Emergency contraceptives and their accompanying potential for increased high-risk behaviors are by no means new to the Duke. The Student Health Center started offering emergency contraceptives in the form of Ovral in August 1996. In 2000, the "morning-after" policy was altered to include advance prescriptions.
Student health officials at the time said they recognized that emergency contraceptives could be used inappropriately, noting that they would provide counseling for women who repeatedly used the pill. With the emergence of Plan B--an emergency contraceptive that, like Ovral, reduces the risk of pregnancy if taken within 72 hours after having unprotected sex--concerns again surfaced, especially given the gentle nature of Plan B when compared to its predecessors.
"Plan B's most common side effects are nausea, abdominal pain, fatigues and headaches, but that happens to only a very small percentage of people who use it," said Rebecca Griesse, a health education specialist in student health. "With the old emergency contraceptives, people would be sick for a day or two." As with students who consistently used Ovral, student health has vowed to educate women who seem to rely too heavily on Plan B as a form of contraception.
"When two people decide not to use a condom, there's not just a risk of pregnancy, so Plan B isn't a perfect fix for all the problems that can come up," Griesse said. "You also have to worry about sexually transmitted diseases."
Hanson noted that there are a significant number of HIV cases in North Carolina college communities right now. "You don't want to get pregnant when you're not planning on it, but in terms of potential disease, HIV is life-threatening, and an emergency contraceptive isn't going to do anything about that," she said.
Griesse added that sexual intercourse that leads to Plan B usage "generally just is not a healthy way to have sexual relations with anyone."
Consistent usage of emergency contraceptives, she said, points to a lack of open communication.
"People need to talk about what... they are going to do to protect themselves from pregnancy or STDs," Griesse said.
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