The COVID-19 pandemic's impact on sexual and reproductive health in Georgia, USA: An exploration of behaviors, contraceptive care, and partner abuse

McCool-Myers, Megan; Kozlowski, Debra; Jean, Valerie; Cordes, Sarah; Gold, Heather; Goedken, Peggy

doi:10.1016/j.contraception.2022.04.010

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…After stratifying by race and ethnicity, PTB decreased in “late” COVID compared to pre-COVID rates among white birthing individuals, which was not observed in Black or Hispanic birthing individuals. Our findings are limited by a small sample size at a single institution yet they are consistent with a body of literature 4 5 that documents persistent racial and ethnic disparities during the COVID pandemic. Although there was a higher odds of PTB in Hispanic PR individuals in “late” COVID versus “early” COVID, the sample size of this population was small and therefore this finding should also be interpreted with caution.…”

Section: Discussionsupporting

confidence: 83%

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States

et al. 2023

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Objective The impact of 2021 vaccination and social restriction reversal on preterm birth (PTB) is unclear. We sought to compare the rates of PTB during the COVID pre- and post- vaccination periods with pre-pandemic rate. Study Design Retrospective cohort comparing all deliveries over 20 weeks at a single tertiary center during ‘early’ (3/2020-6/2020) vs. ‘late’ COVID (3/2021–6/2021), and 'late' COVID vs. pre-COVID (3-6/2014-2019). PTB<37weeks, <34weeks and <28weeks were compared and stratified by race/ethnicity. Results 16483 deliveries occurred including 2068 ‘early’ COVID, 2115 ‘late’ COVID and 12300 pre-COVID. The PTB rate during ‘late’ COVID was lower compared to ‘early’ COVID (12.1% vs 14.6%,p=0.02). Rate of PTB<34 was also lower during ‘late’ COVID (4.4% vs 5.7%, p=0.05). PTB<28 did not differ. When controlling for prior PTB, ‘late’ COVID remained associated with a decreased risk of PTB compared to ‘early’ COVID, aOR 0.82 [95%CI:0.68,0.98]. Although there was no difference in PTB among Hispanic individuals when comparing ‘late’ COVID versus pre-COVID, when further sub-divided, a small number of Hispanic Puerto Rican(PR) individuals had higher odds of PTB<37 during late’ COVID versus pre-COVID (aOR:4.29 [95%CI 1.12,16.4]) (Table). Additionally, White individuals had reduced odds of PTB<37 (aOR 0.80[95%CI 0.65, 0.98]) during ‘late’ COVID versus pre-COVID while the PTB rate was unchanged when comparing ‘late’ COVID versus pre-COVID in all other racial and ethnic groups. Conclusion During 2021, PTB rates decreased from rates observed in 2020 at the height of COVID restrictions. Among White birthing individuals, PTB decreased in 2021 compared to pre-COVID rates. This decrease was not observed in Black and Hispanic birthing individuals. These data highlight the continued racially disparate impact of the COVID pandemic on PTB rates.

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Section: Discussionsupporting

confidence: 83%

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States

et al. 2023

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“…This nationally representative, serial cross-sectional survey adds to an existing body of evidence that there has been an increase in the number of barriers experienced while trying to access reproductive health services over the past few years, with individuals from historically disadvantaged populations experiencing the largest increases in barriers to care. However, our findings also suggest that significant barriers to reproductive health services existed in 2017.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Frequency and Type of Barriers to Reproductive Health Care Between 2017 and 2021

Adler

Biggs²,

Kaller³

et al. 2023

JAMA Netw Open

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ImportancePrevious research has documented individual-level barriers to reproductive health services, but few studies have examined national trends.ObjectiveTo determine whether the number and type of barriers to reproductive health care experienced by US women of reproductive age changed from 2017 to 2021.Design, Setting, and ParticipantsThis cross-sectional study used serial survey data, weighted to be nationally representative, collected in August 2017 and December 2021 from members of Ipsos’s KnowledgePanel who were aged 18 to 49 years and assigned female at birth.ExposuresHaving experienced barriers to reproductive health care over the past 3 years.Main Outcomes and MeasuresThe primary outcome was number and type of barriers to reproductive health care services, including Papanicolaou tests or birth control, experienced in the past 3 years. Increases in barriers to reproductive health care were measured using multivariable linear regressions adjusted for age, race and ethnicity, education level, employment status, metropolitan area, geographic region, household income, and language (English vs Spanish).ResultsOf 29 496 KnowledgePanel members invited, 7022 (mean [SD] age, 33.9 [9.0] years) and 6841 (mean [SD] age, 34.2 [8.6] years) completed the 2017 and 2021 surveys (50% and 45% response rates, respectively). Among 12 351 participants who indicated that they had ever tried accessing reproductive health services, 35.9% (95% CI, 34.8%-37.0%) were aged 30 to 39 years; 5.5% (95% CI, 4.9%-6.2%) were Asian or Pacific Islander, 13.7% (95% CI, 12.8%-14.6%) were Black, 19.1% (95% CI, 18.1%-20.1%) were Hispanic, 58.2% (95% CI, 57.0%-59.5%) were White, and 3.5% (95% CI, 3.1%-4.0%) were multiracial or of other race or ethnicity; and 11.7% (95% CI, 11.0%-12.5%) were living below 100% of the federal poverty level. Covariate distribution was similar across years. In bivariable analyses, participants were more likely to report experiencing a given barrier in the past 3 years in 2021 than in 2017 for all but 2 barriers. More people experienced 3 or more barriers in 2021 (18.6%; 95% CI, 17.3%-20.0%) than in 2017 (16.1%; 95% CI, 14.9%-17.4%) (P = .008). In multivariable analyses, the mean number of barriers increased significantly from 1.09 (95% CI, 1.02-1.14) in 2017 to 1.29 (95% CI, 1.22-1.37) (P &lt; .001) in 2021. Participants who were aged 25 to 29 years (0.42; 95% CI, 0.37-0.47), identified as Hispanic (0.41; 95% CI, 0.38-0.45), had no high school diploma or General Educational Development test (0.62; 95% CI, 0.53-0.72), lived below 100% of the federal poverty level (0.65; 95% CI, 0.55-0.73), and took the survey in Spanish (0.87; 95% CI, 0.73-1.01) saw the greatest increases in mean number of barriers between 2017 and 2021.Conclusions and RelevanceThe study findings suggest that barriers to reproductive health care increased between 2017 and 2021, with the largest increases observed among individuals from historically disadvantaged populations. Efforts are needed to ensure that reproductive health care access remains a priority.

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“…Similarly, studies in the general population have shown lower sexual function scores compared to the pre-pandemic period, decreased frequency of sexual intercourse [57], decreased sexual satisfaction, increased sexual difficulties, and sexual stress during lockdown [58]. Also, access to contraceptive methods became complex, and the negative sexual and reproductive health experiences increased during the pandemic [59]. Hence, it is expected that the physical, psychosocial, and sexual health indicators in patients with RA could be even more affected during the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives

Ledón-Llanes,

Contreras-Yáñez,

Guaracha-Basáñez

et al. 2024

PLoS ONE

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Background Rheumatoid arthritis (RA) is one of the most prevalent rheumatic diseases that harms all aspects of patients’ lives, including sexual and reproductive health (SRH), often neglected in patients’ care. The study aimed to explore the sexual and reproductive experiences of Mexican outpatients with RA from a narrative perspective. Patients and methods From July 2020 to October 2021, 30 adult patients with RA from the Department of Immunology and Rheumatology outpatient clinic of a national referral center for rheumatic diseases had in-depth interviews audiotaped, transcribed, and analyzed using a thematic analysis approach. Results are presented in a descriptive and interpretative manner and integrated into a theoretical model for the topic understanding. Results Five intertwined major themes emerged: I) RA onset: Absence of SRH contents, II) Healthcare for RA: Emerging SRH contents, III) RA’s impact: Proliferation of SRH contents, IV) Coping with the process of living with RA: SRH-related strategies, and V) The impact of the COVID-19 pandemic on patients’ experiences: Increased SRH burden. SRH contents emerged through these major themes (but at RA onset), mostly when inquired and mainly when narrating the RA impact and coping. Patients identified that RA affected their couple dynamics, sexual function, and reproductive project. The SRH care was considered relevant but limited and focused on reproductive contents. It worsened during the COVID-19 pandemic. We proposed a theoretical model where patients’ SRH experiences are embedded across their RA biography and integrated with the RA impact and the copy with the disease process. These intertwined experiences were also evident during the COVID-19 pandemic, which challenged participants’ biopsychosocial resources. Conclusions The sexual and reproductive experiences narrated by the RA outpatients concerning their disease-related biography showed that even when the SRH appeared as not prioritized at the disease onset, it was widely expressed during the process of living and coping with the disease and was additionally affected by the COVID-19 pandemic.

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The COVID-19 pandemic's impact on sexual and reproductive health in Georgia, USA: An exploration of behaviors, contraceptive care, and partner abuse

Cited by 8 publications

References 21 publications

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States

Preterm Birth Rates and Racial Disparities during the COVID-19 Pandemic at a Single Institution in the Southeastern United States

Changes in the Frequency and Type of Barriers to Reproductive Health Care Between 2017 and 2021

Sexual and reproductive health while living with rheumatoid arthritis: The impact of the disease stage on patient perspectives

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