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Barriers to contraception access and use among youth: A scoping review in high-income countries
Bronte K Johnston1, Patricia A Janssen1, Mika Ohtsuka1
1School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
Background:
The United Nations (UN) has a target for universal contraception access by 2030. Youth (aged 15-29) still have limited contraception access and lower usage. A unified understanding of the barriers youth face in high-income countries (HIC) remains unclear.
Objectives:
Synthesized evidence on youth contraception barriers across HIC to identify continued healthcare inaccessibility and knowledge gaps.
Search Strategy:
A search strategy, including terms like "youth" and "barriers," was applied to three databases, identifying articles published between January 2013-September 2024.
Selection Criteria:
Primary peer-reviewed quantitative, qualitative, and mixed-methods studies were included if they focused on youth and contraception barriers.
Data Collection And Analysis:
Following the Joanna Briggs Institute, articles were screened for inclusion, and data was extracted. Analyses included descriptive statistics and summarizing findings for quantitative and qualitative results. All articles were subjected to inductive and deductive content analysis to map barriers. Article quality was appraised by the Mixed Methods Appraisal Tool.
Main Results:
A total of 41 articles were included, of which 88% were from the USA. Youth struggled to receive quality contraception care from multiple access points from health systems and youth perspectives. Barriers included youth minimal knowledge, poor approachability and care appropriateness, physical barriers, costs, stigma, confidentiality concerns, and service gatekeeping. Youth experiences varied by social identities with those from lower economic, rural, and of younger age facing more obstacles.
Conclusions:
Contraception was inaccessible for many. To meet UN targets, efforts need to address described barriers to ensure accessible and equitable contraception care that respects and supports youth's choices.
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