Abstract
OBJECTIVES: To examine demographic, socioeconomic, and regional differences between in-person and telehealth contraception visits and telehealth visit quality in the US during the COVID-19 pandemic. METHODS: In July 2020 and January 2021, we surveyed reproductive-aged women about experiences seeking contraception. We created a COVID-19 hardship score assessing pandemic-related job, income, and housing loss and a telehealth quality score assessing telehealth visit convenience, communication, and privacy. We used chi-square tests and multivariable logistic regression to examine relationships between baseline variables and in-person vs. telehealth visits and telehealth quality scores. RESULTS: Among 2,028 respondents who answered questions about contraception visits, 1,490 (73.4%) reported any visit, of which 530 (35.6%) were telehealth. In adjusted analyses, respondents identifying as Hispanic/Latina and mixed race/other (adjusted OR (aOR), 0.59 and 0.36, respectively), from the South, Midwest, or Northeast (aOR, 0.63, 0.64, 0.52, respectively), without insurance (aOR 0.63), and with greater COVID-19 hardship (aOR 0.52) had significantly lower odds of attending any visit (all p<0.05). Among respondents with any visit for contraception, respondents from the Midwest and South had significantly lower odds of having a telehealth versus in-person visit (aOR 0.63 and 0.54 respectively, p<0.01). Hispanic/Latina respondents and those in the Northeast had significantly lower odds of reporting high telehealth quality (≥75th percentile) (aOR 0.53 and 0.65, respectively, p<0.05). CONCLUSIONS: Disparities in telehealth usage for contraception among people identifying as Hispanic/Latina and people in the South and Midwest, and in telehealth quality among Hispanic/Latina people. Further research should focus on patients’ desires around telehealth and increasing access to telehealthcare.