When There's No Plan B

It’s a Saturday night and the condom broke. A guy tells his girlfriend that he’ll go to the local pharmacy to get emergency contraception only to come home empty-handed.

A recent study by David Bell, associate professor of Population and Family Health at the Mailman School, employed three “mystery shoppers”—young men ages 19, 25, and 28—who attempted to purchase emergency contraception, or Plan B, at 158 pharmacies in three New York City neighborhoods. All told, there was a one in five chance that they were unsuccessful. (The findings appear in the journal Contraception.)

By far the biggest barrier they encountered was that pharmacists asked for the presence of a female or her ID—despite the fact that this has never been part of federal requirements around the drug. Emergency contraception has always been available to men and women. At the time of the study, the law restricted the drug to those ages 17 and older. Technically, the drug is now available to all ages over the counter, but buying it could still involve asking a pharmacist since the drug may be under lock and key.

Another barrier is cost. Plan B goes for $50, and the generic version is only slightly cheaper. “For a teenager or young adult, that is a hefty cost,” says Bell, whose study found the drug to be more expensive on the Upper East Side, and slightly less in East Harlem and Washington Heights. Another neighborhood difference:  pharmacies in less affluent areas had fewer long hours. Says Bell, “After five [p.m.] on Saturdays and Sundays could be prime time for the use of emergency contraception.”

Some question why it’s important that men access to emergency contraception, when it’s women who use the drug. Bell answers that it’s a matter of shared responsibility: “We give a lot of lip service to including men in responsible sexual and reproductive health behaviors, and this is one way that they can. But if we’re putting barriers for them to actualizing that responsibility, it’s our fault, not theirs.”

A medical director of the Young Men’s Health Clinic on 168th Street in Manhattan, Bell makes sure his patients know what emergency contraception is and how to get it, including alternatives like Planned Parenthood, which has the drug for little or no cost. Says Bell, “Part of my talk is explaining how to put a condom on properly, and what to do if it breaks.”