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Dual-Method Contraception Use Among Young Women Pre- and Post-ACA Implementation.

Tiffany M Montgomery1, Alisa J Stephens-Shields2, Marilyn M Schapira2

  • 1Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA.

Policy, Politics & Nursing Practice
|May 14, 2020
PubMed
Summary
This summary is machine-generated.

The Affordable Care Act (ACA) mandate increased access to contraception but did not change dual-method use. Researchers found no link between contraception shifts and rising sexually transmitted disease (STD) rates in young women.

Keywords:
Patient Protection and Affordable Care Actcondomscontraception behaviorlong-acting reversible contraceptionyoung adult

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Area of Science:

  • Public Health
  • Reproductive Health
  • Epidemiology

Background:

  • The Patient Protection and Affordable Care Act (ACA) contraceptive coverage mandate aimed to reduce financial barriers to contraception.
  • Post-ACA, increases in sexually transmitted disease (STD) rates have been observed, particularly among Black adolescent and young adult women.
  • The association between changes in contraception use patterns and rising STD rates remains unclear.

Purpose of the Study:

  • To investigate whether changes in dual-method contraception use are associated with increased STD rates among adolescent and young adult women after the ACA contraceptive coverage mandate.
  • To compare contraception use patterns before and after the ACA implementation.

Main Methods:

  • A repeated cross-sectional analysis using data from the National Survey for Family Growth (2006-2010 and 2013-2015 cohorts).
  • Comparison of short-acting reversible contraception (SARC) and long-acting reversible contraception (LARC) use pre- and post-ACA.
  • Analysis of dual-method contraception use (including condoms) across different demographic groups and contraception users.

Main Results:

  • A significant decrease in SARC use (78.2% to 67.5%) and a significant increase in LARC use (8.9% to 21.8%) were observed post-ACA.
  • No significant change in dual-method contraception use was found among SARC users, LARC users, or between White and Black women.
  • The study found no direct association between changes in contraception methods and decreased condom use, thus no indirect association with increased STD rates.

Conclusions:

  • Changes in contraception use following the ACA mandate were not directly associated with decreased condom use or increased STD rates.
  • Consistent condom use promotion remains crucial for STD prevention.
  • Further research is necessary to elucidate the reasons behind the rise in STD rates among Black women in the post-ACA era.