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

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.