Young People's Support for and Personal Interest in an Advance Provision Model for Medication Abortion

To assess young people's interest in advance provision (AP) of medication abortion-receiving mifepristone and misoprostol from a clinician in advance for their future use.

From November 2022-August 2023 we administered an electronic survey regarding advance provision to patients assigned female at birth at four Bay Area youth-serving clinics.

Among 152 people ages 14-24 years (mean 17.9) surveyed, 73.7% (95% CI, 65.9%-80.5%) supported and 46.1% (95% CI, 37.9%-54.3%) were interested in the AP model. AP interest was higher among people who experienced three or more difficulties trying to access reproductive healthcare (70.6% [95% CI, 44.0%-89.7%]) and who experienced food or housing insecurity (60.3% [95% CI, 46.6%-73.0%]). Most youth (81.6%) had a safe place to store the pills for later use; this proportion was significantly higher among people ages 18-24 years (88.5%) than teens ages 14-17 years (74.3%, P = .025). The most common perceived advantages of AP included being able to have the abortion earlier in pregnancy (61.8%), privacy (57.9%) and convenience (50.7%). Common disadvantages noted included concern that people might take the pills incorrectly (50.0%) or lose the pills (40.1%).

Young people have considerable interest in AP of medication abortion. Further research is needed to document the AP model's feasibility, clinical outcomes, and effect on access for adolescents.