91. COVID-19 Impacts and Videoconference Healthcare Preferences in Relation to Depression and Sexual Risk Behaviors Among Female Young Adults Seeking Sexual and Reproductive Health Care

Abstract

The COVID-19 pandemic may disproportionately affect young women with depression, who are at increased risk of adverse sexual and reproductive health (SRH) outcomes. We sought to characterize 1) pandemic impacts on mood and healthcare access, and 2) experience and comfort with videoconference healthcare among young women seeking SRH care. We then determined associations of pandemic impacts and videoconference healthcare preferences with depression and SRH risk. We recruited patients from Planned Parenthood of Wisconsin (PPWI) health centers to take an anonymous online survey in preparation for a behavioral intervention trial (May-September 2021). Eligible patients were 21-24 years old, were biologically able to become pregnant, and had visited a PPWI health center in the past two years (N=98). Questions included demographic information, past-2-week depressive symptoms [Patient Health Questionnaire (PHQ)-8, depression defined as score ≥10]; past-3-month SRH risk [inconsistent/no condom use, sex within two hours after substance use, low-effectiveness contraception, >1 partner, sexually transmitted infection treatment]; impact of the COVID-19 pandemic on mood and on ease of getting healthcare; experience with videoconference healthcare; and comfort with videoconference healthcare (experienced or hypothetically), including technological aspects, talking with a provider, and privacy to discuss sensitive topics. Nonparametric bivariate tests examined associations of pandemic impacts and videoconference healthcare responses with depression and SRH risk. Most respondents identified as White (66%) or Black/African American (17%); 30% identified as Hispanic/ Latinx. Twenty-nine percent had depression by PHQ-8 score. Of those reporting sex in the past 3 months (89%), 87% reported ≥1 SRH risk. Respondents endorsing ≥1 recent SRH risk were more likely to have depression than those with no recent SRH risk (34% vs. 9%, p<.022). Most respondents reported that the COVID-19 pandemic had worsened their mood (a little worse, 47%; a lot worse, 29%), which was associated with depression (in 17% of those reporting mood better; 20%, mood a little worse; 57%, mood a lot worse; p<.003). Nearly 9 out of 10 whose mood was a little worse due to the pandemic (89%) reported ≥1 recent SRH risk vs. 75% of those whose mood was a lot worse and 67% of those whose mood was better (p=.171). Thirty percent reported difficulty getting healthcare due to the pandemic. There was no difference in difficulty getting healthcare due to the pandemic by depression or SRH risk. Almost one-half (44%) had participated in videoconference healthcare. Most reported comfort with videoconference healthcare (experienced or hypothetical), including technological aspects (61%), talking with a provider (55%), and privacy to discuss sensitive topics (57%). There were no differences in receipt of or comfort with videoconference healthcare according to depression or SRH risk. The COVID-19 pandemic resulted in worse mood and difficulty getting healthcare for some young women, which may increase their SRH care needs associated with depressive symptoms and risk behaviors. Videoconferencing may be an acceptable means of addressing unmet SRH care needs for young women regardless of depressive symptoms. Department of Health and Human Services Office of Population Affairs (Grant Number 1 TP2AH000076-01-00).