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April 01, 2024
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Contraception sources differ for adolescent, young adults based on sociodemographics

Fact checked byRichard Smith
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Key takeaways:

  • Most adolescents and young adults accessed contraception through routine outpatient care settings.
  • Contraception sources differed based on insurance status, age and residence.

Sources for contraception differed among adolescents and young adults based on sociodemographic factors such as insurance status, age and residential area, according to a research letter published in JAMA Pediatrics.

“Although routine outpatient care settings are the most common source of contraception among adolescents and young adults, uninsured and older adolescents and young adults are more likely to access contraception in reproductive health safety net clinics — such as family planning clinics or school-based clinics — and adolescents and young adults living in rural settings are more likely to access contraception in acute care facilities,” Michelle Shankar, MD, general pediatrician and postdoctoral fellow in the National Clinician Scholars Program at Yale University School of Medicine, told Healio. “These findings highlight how important it is to make sure clinicians are equipped to provide high-quality, patient-centered and evidence-based contraceptive health care in any health care setting.”

Where women access contraception
Data derived from Shankar M, et al. JAMA Pediatr. 2024;doi:10.1001/jamapediatrics.2024.0111.

Shankar and colleagues evaluated cross-sectional data from 7,505,572 adolescents and young adults aged 15 to 24 years who responded to the 2017 to 2019 National Survey of Family Growth (NSFG). All respondents reported receiving contraception in the past 12 months. Researchers assessed factors associated with contraception access from reproductive health safety net clinics and acute care settings compared with routine outpatient care settings as the control.

Overall, 79.3% of respondents were aged 18 to 24 years, 39.6% had an income at least 250% of the federal poverty level, 64% had private insurance and 36.6% lived in urban areas; 83% of respondents accessed contraception through routine outpatient care settings.

Michelle Shankar

Uninsured respondents were more likely to access contraception through reproductive health safety net clinics, with an estimated probability of 23.8% compared with 7.6% among privately insured respondents (adjusted OR = 3.94; 95% CI, 1.38-11.25). Older respondents were more likely to access contraception in reproductive health safety net clinics, with an estimated probability of 11.4% compared with 4.7% among younger respondents (aOR = 2.7; 95% CI, 1.06-6.9). Respondents living in rural areas were more likely to access contraception from acute care facilities, with an estimated probability of 12.6% compared with 3.6% among those living in urban areas (aOR = 4.09; 95% CI, 1.03-16.21).

“As this study uses data from the 2017 to 2019 NSFG, moving forward we need to build upon this research to understand how the COVID-19 pandemic and recent changes to state laws may have potentially shifted how adolescents and young adult patients access reproductive health care,” Shankar said. “The NSFG occurs every 2 years, so data from 2020 to 2022 should be available to analyze soon.”

For more information:

Michelle Shankar, MD, can be reached at michelle.shankar@yale.edu or @shankarmichelle on X (Twitter).