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Use of telemedicine to obtain contraception among young adults: Inequities by health insurance.

Contraception 2024 March 10
OBJECTIVE: The objective of this study was to describe use of telemedicine for contraception in a sample of young adults and examine differences by health insurance coverage.

STUDY DESIGN: We analyzed survey data collected May 2020-July 2022 from individuals at risk of pregnancy aged 18-29 recruited at 29 community colleges in California and Texas. We used multivariable mixed-effects logistic regression models with random effects for site and individual to compare use of telemedicine to obtain contraception by insurance status, sociodemographic characteristics, and state.

RESULTS: Our analytic sample included 6,465 observations from 1,630 individuals. Participants reported using a contraceptive method obtained through telemedicine in just 6% of observations. Uninsured participants were significantly less likely than those privately insured to use contraception obtained through telemedicine (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.31-0.97), as were participants who did not know their insurance status (aOR, 0.54; 95% CI, 0.29-0.99). Texas participants were less likely to use contraception obtained via telemedicine than those in California (aOR, 0.42; CI: 0.25-0.69).

CONCLUSIONS: Few young people in this study obtained contraception through telemedicine, and insurance was crucial for access in both states.

IMPLICATIONS: Although telemedicine holds promise for increasing contraceptive access, we found that few young adults were using it, particularly among the uninsured. Efforts are needed to improve young adults' access to telemedicine for contraception and address insurance disparities.

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