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Perceived Access to Contraception via Telemedicine Among Young Adults: Inequities by Food and Housing Insecurity
Jennifer Yarger1, Kristine Hopkins2, Sarah Elmes3
1Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 550 16th Street, San Francisco, CA, 94158, USA. jennifer.yarger@ucsf.edu.
Background:
Telemedicine expanded rapidly during the COVID-19 pandemic, including for contraceptive services. Data are needed to understand whether young people can access telemedicine for contraception, especially in underserved populations.
Objective:
To compare young people's perceived access to telemedicine visits for contraception during the COVID-19 pandemic by food and housing insecurity.
Design:
Supplementary study to a cluster randomized controlled trial in 25 community colleges in California and Texas. Online surveys were administered May 2020 to April 2021. Mixed-effects logistic regression models with random effects for site were used to examine differences in access to contraception through telemedicine by food and housing insecurity status, controlling for key sociodemographic characteristics, including race/ethnicity, non-English primary language, health insurance status, and state of residence, and contraceptive method used.
Participants:
1,414 individuals assigned female at birth aged 18-28.
Main Measures:
Survey measures were used to capture how difficult it would be for a participant to have a telemedicine visit (phone or video) for contraception.
Key Results:
Twenty-nine percent of participants were food insecure, and 15% were housing insecure. Nearly a quarter (24%) stated that it would be difficult to have a phone or video visit for contraception. After accounting for sociodemographic factors and type of method used, food insecure (adjusted odds ratio [aOR], 2.17; 95% confidence interval [CI], 1.62-2.91) and housing insecure (aOR, 1.62; 95% CI, 1.13-2.33) participants were significantly more likely to report that it would be difficult to use telemedicine for contraception during the pandemic.
Conclusions:
Underserved patients are those who could benefit most from the expansion of telemedicine services, yet our findings show that young people experiencing basic needs insecurity perceive the greatest difficulty accessing these services for essential reproductive care.
Trial Registration:
ClinicalTrials.gov Identifier: NCT03519685.
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