Factors Associated With Contraception Use Among Active Duty Service Members at a Large Military Base

Area of Science:

• Public Health
• Military Medicine
• Sexual and Reproductive Health

Background:

• Active duty service members (ADSMs) exhibit higher unintended pregnancy rates than the general population.
• Despite military initiatives for sexual and reproductive healthcare services (SRH), access barriers persist for ADSMs.

Purpose of the Study:

• To investigate the prevalence and nature of barriers encountered by ADSMs when accessing SRH.
• To identify factors associated with emergency contraception use among ADSMs.

Main Methods:

• A survey was administered to ADSMs with access to no-cost, walk-in SRH.
• Descriptive statistics, univariable, and multivariable logistic regression analyses were employed to examine SRH outcomes and associated characteristics.

Main Results:

• Over half of ADSMs seeking SRH reported barriers, including feeling judged, lack of service awareness, appointment difficulties, and work conflicts.
• Female ADSMs were more likely to report barriers than male ADSMs.
• Emergency contraception use was associated with younger age (<25 years) and the perception that seeking SRH could harm one's career.

Conclusions:

• ADSMs frequently encounter perceived judgment and systemic obstacles in accessing SRH.
• Enhanced efforts are needed to destigmatize SRH and improve patient-centered access for ADSMs.