Use of preferred contraceptive method among young adults in Texas and California: A comparison by state and insurance coverage.

Autor: Hopkins K; Population Research Center, The University of Texas at Austin, Austin, Texas, United States of America., Yarger J; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America.; Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, United States of America., Rossetto I; Population Research Center, The University of Texas at Austin, Austin, Texas, United States of America., Sanchez A; Population Research Center, The University of Texas at Austin, Austin, Texas, United States of America., Brown E; Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Odessa, Texas, United States of America., Elmes S; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America., Mantaro T; Health Services and Promotion, Dallas College, Dallas, Texas, United States of America., White K; Population Research Center, The University of Texas at Austin, Austin, Texas, United States of America.; Steve Hicks School of Social Work, The University of Texas at Austin, Austin, Texas, United States of America., Harper CC; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2023 Aug 31; Vol. 18 (8), pp. e0290726. Date of Electronic Publication: 2023 Aug 31 (Print Publication: 2023).
DOI: 10.1371/journal.pone.0290726
Abstrakt: Background: Young people's ability to use their preferred contraceptive method is an indicator of reproductive autonomy and healthcare access. State policies can hinder or facilitate access to a preferred contraceptive method.
Objective: This study compared use of preferred contraceptive method in Texas and California, states with contrasting health policy contexts that impact health insurance coverage and access to subsidized family planning services.
Methods: We used baseline survey data from an ongoing cluster randomized controlled trial of sexually active students, assigned female at birth, ages 18-25, at 29 community colleges in Texas and California (N = 1,974). We described contraceptive preferences and use, as well as reasons for nonuse of a preferred method. We conducted multivariable-adjusted mixed-effects logistic regression analyses for clustered data, and then calculated the predicted probability of using a preferred contraceptive method in Texas and California by insurance status.
Results: More Texas participants were uninsured than Californians (30% vs. 8%, p<0.001). Thirty-six percent of Texas participants were using their preferred contraceptive method compared to 51% of Californians. After multivariable adjustments, Texas participants had lower odds of using their preferred method (adjusted odds ratio = 0.62, 95% confidence interval = 0.48-0.81) compared to those in California. Texas participants in all insurance categories had a lower predicted probability of preferred method use compared to California participants. In Texas, we found a 12.1 percentage-point difference in the predicted probability of preferred method use between the uninsured (27.5%) and insured (39.6%) (p<0.001). Texans reported financial barriers to using their preferred method more often than Californians (36.7% vs. 19.2%, p<0.001) as did the uninsured compared to the insured (50.9% vs. 18.7%, p<0.001).
Conclusion: These findings present new evidence that state of residence plays an important role in young people's ability to realize their contraceptive preference. Young people in Texas, with lower insurance coverage and more limited access to safety net programs for contraceptive care than in California, have lower use of preferred contraception. It has become urgent in states with abortion bans to support young people's access to their preferred methods.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2023 Hopkins et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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