Barriers to Obtaining Long-Acting Reversible Contraception Among Low-Income Women [09I

Abstract

INTRODUCTION: Low-income women in the United States shoulder a disproportionate burden of unintended pregnancy, reflecting possible difficulties in accessing contraception. We examined the association between income and barriers to obtaining long-acting reversible contraception (LARC). METHODS: Non-pregnant women aged 18 to 40 years completed an electronic, cross-sectional survey at the University of Minnesota Driven to Discover Research Facility at the Minnesota State Fair in 2018. Participants reported being biologically capable of pregnancy and sexually active with a male partner. Bivariate analyses examined perceptions of LARC, barriers to LARC, and LARC use by participants’ income status: low income (less than or equal to 200% of federal poverty guideline) versus higher income. This study was deemed IRB exempt. RESULTS: Low-income women (n=91) were more likely than higher income women (n=274) to encounter at least one perceived barrier to obtaining a LARC method (70% vs 47%, P<.01), to identify more concerns about LARC use (3.1 vs 2.5, P<.01), and note more bothersome side effects (4.2 vs 3.5, P=.02). Cost of LARC was the most frequently identified barrier and was of greater concern to low-income women (53% vs 32%, P<.01). However, there was a trend toward low-income women being less likely to choose LARC as their preferred method even if cost barriers were removed (35% vs 46% P=.06). CONCLUSION: Low-income women experience more barriers to access but also more negative perceptions of LARC. Efforts to increase access to LARC should address these barriers and focus on concerns more common among low-income women regarding LARC use.