Suspect online sellers and contraceptive access

Background: Issues surrounding contraception access have been a national focus. During this debate, adolescent and adult women may seek these products online. Due to safety concerns, including potential counterfeit forms, we wished to assess whether online no prescription contraceptives were available. Study Design: We assessed online availability of reversible, prescription contraceptive methods resulting in <10 undesired pregnancies/year, i.e., Depo-Provera shot; oral contraceptives; NuvaRing; Ortho Evra patch; Paragard and Mirena IUDs; and Implanon/Nexplanon implants. Using Google search buy ITEM no prescription, we reviewed the first five result pages for no prescription vendors. Searches were conducted 1/3/2012-2/20/2012. Results: All contraceptives were available as no prescription products. Furthermore, IUDs were advertised as over-the-counter and YouTube videos provided how to videos, including a cartoon version. We also found that illicit online pharmacy marketing is shifting from direct search engine access to social media (Facebook, Twitter, Slidehare, flickr). Conclusion: Online contraceptive sales represent patient safety risks and a parallel system of high-risk product access absent professional guidance. Providers should educate patients, while policy makers employ legal strategies to address these systemic risks. (C) 2012 Elsevier Inc. All rights reserved.