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My Contraception Tool (MCT) applies the principles of multi-criteria decision analysis to the choice of contraceptive method. Its purpose is to make the decision-making process transparent to the user and to suggest a method to them based on their own preferences. The contraceptive option that emerges as optimal from the analysis takes account of the probability of a range of outcomes and the relative weight ascribed to them by the user. The development of MCT was a collaborative project between London School of Hygiene & Tropical Medicine, Brook, FPA and Maldaba Ltd. MCT is available online via the Brook and FPA websites. In this article we describe MCT's development and how it works. Further work is needed to assess the impact it has on decision quality and contraceptive behaviour.

Background and methodology Little evidence is available on the extent to which one-stop shops address users9 sexual health needs and the extent to which they identify additional needs users may not have identified. As part of the One-Stop Shop Evaluation, a questionnaire was designed to compare the reasons for users9 visits and the reported outcomes of visits at a one-stop shop with the experiences of users in separate genitourinary medicine (GUM) and contraceptive clinics. Results The difference in the proportions of those attending the one-stop shop and those attending the control sites services for a sexually transmitted infection (STI)-related reason who were diagnosed with an STI was minimal, but those attending for an STI-related reason in the one-stop shop were more likely to receive an additional contraceptive outcome. Women attending for a contraceptive-related reason at the one-stop shop were more likely to have an STI screen than those attending the control sites for the same reason, but there was little difference in the proportions amongst this group receiving an STI diagnosis or receiving treatment. When focusing on women attending for a pregnancy-related reason, one-stop shop users were more likely to have received contraceptive advice or supplies. Discussion and conclusions It was not possible in our evaluation to determine the relative effectiveness of the one-stop shop in comparison to the traditional GUM and contraceptive clinics in improving sexual health status, however the one-stop shop was more likely to address additional sexual health needs that service users may not have previously identified.

This article discusses the complex process of contraceptive decision-making and how many times methods are chosen according to personal beliefs and the beliefs of health care workers. It makes a case for the development of contraceptive decision aids to improve sustained and correct use of methods and provides information on the future research as well as the role of decision aids.

High rates of sexually transmitted infections (STIs) and unplanned pregnancy amongst young people in England emphasize the need to explore innovative ways of delivering sexual health information. The National Teenage Pregnancy Strategy and the National Strategy for Sexual Health and HIV advocate better sexual health education. The latter states: "Information on sexual health is often uncoordinated or poorly targeted. It is not consistently accessible and doesnt make enough use of new media and technology". The Internet is a practical accessible tool for increasing sexual health awareness. Sexual health sites can be particularly valuable information sources for young people who have trouble accessing sexual health services and can be used to publicise services by providing information that tackles access barriers (e.g. confidentiality for all ages free emergency contraception how to get there and so on). Access content site quality and level of maintenance are four components we feel should be considered prior to the development of sexual health sites. We present these as a starting point to encourage further debate on the use and evaluation of the Internet in sexual health promotion and to build on Susan Quilliams review of self-help websites in this issue of the journal. (excerpt)