Self-Care for Sexual and Reproductive Health: Results From the French 2023 National Survey on Sexuality and Sexual...

Digital platforms have accelerated sexual and reproductive health (SRH) self-care practices, but evidence is limited regarding the demand and usage of these resources and their potential to reduce SRH inequities.

We draw on the CSF-2023 study, a national cross-sectional survey on sexuality in France. Our sample included 6305 sexually active individuals aged 18-49 who reported on SRH digital health care practices. We conducted logistic regressions to identify factors influencing the acceptability, information-seeking, and purchasing of services online across SRH domains (oral contraception, medication abortion pills, sexually transmitted infection/HIV treatment, and sexual enhancement).

Men demonstrated higher acceptance of SRH online self-care than women (59% vs. 53%), although overall acceptability was low (ranging from 10% for medication abortion pills to 23% for HIV Prep). Women sought more information about any topic (75% vs. 70%) and contraception and abortion specifically, while men focused more on sexual enhancement. Younger, more educated respondents and those with multiple partners or who met partners online sought a wider range of information. Acceptance was greater among men who had sex with men and respondents who reported sexual violence or unintended pregnancies, whereas rural residents were less accepting and sought less information. Recent medical care correlated with lower acceptance but did not affect information-seeking.

This study highlights a limited interest in digital prescription-free SRH services in France, despite increasing reliance on digital platforms for SRH information. Targeted programmatic and policy investments are needed to bridge the digital divide, improve service quality, and explore alternative in-person channels for SRH self-care needs.