A Content Analysis of Reddit Users' Posts about Challenges to Contraceptive care-seeking during COVID-19-related Restrictions in the United States.

The COVID-19 pandemic in the United States caused disruptions in care seeking and delivery during the spring of 2020, including for contraceptive care. We examined how some individuals experienced and responded to barriers to accessing contraceptive care by conducting a content analysis of relevant Reddit posts. We collected 2666 posts by scraping relevant subreddits from February 1, 2020, to April 15, 2020, and filtering by selected keywords. Among the 101 posts on contraception and the COVID-19 pandemic, we explored three main themes: barriers to accessing general healthcare during the early pandemic, problems and concerns specific to contraceptive use, and attempts to navigate the obstacles to contraceptive care or use-related concerns. The Reddit posts demonstrated the disruptive force the early pandemic had on contraceptive care and provided a unique window into the concerns posters expressed on Reddit during this time. Many posters asked questions related to accessing contraception and side effects and sought reassurance from these online forums. Our results suggest that there were barriers to accessing reliable, high-quality, and evidence-based information about contraception during this disruption in care. The findings also underscore that conversational and interactive means of seeking out information are important modes for learning about and discussing contraception for some and may be especially helpful during clinic closures and other restrictions on access.

Financial Instability and Delays in Access to Sexual and Reproductive Health Care Due to COVID-19.

Objective: To identify prevalence of, and patient and clinic characteristics associated with, delays in access to sexual and reproductive health (SRH) care due to the COVID-19 pandemic across three states with varying COVID-19 context and state government response. Methods: We weighted data collected between May 2020 and May 2021 from monthly and biannual follow-up surveys of patients seeking family planning care at a publicly supported health center in Arizona (N = 538), Iowa (N = 341), and Wisconsin (N = 568), who reported on experiences 6-18 months before the survey. We conducted multivariable logistic regression analyses to identify characteristics associated with delays in accessing SRH care due to COVID-19, with specific attention to associations between patients' financial instability and experiencing delays. Results: Between May 2020 and May 2021, over half of respondents in Arizona (57%), 38% in Iowa, and 30% in Wisconsin indicated that they were either unable to access or delayed accessing SRH care or a contraceptive method due to the COVID-19 pandemic. In Arizona and Wisconsin, in multivariable models, respondents who had experienced financial instability due to being out of work, having fallen behind on key life payments, or because of a job reduction or loss due to COVID-19 had increased odds of experiencing COVID-19-related SRH care delays (Arizona adjusted odds ratio [aOR] = 2.6, p = 0.01 and Wisconsin aOR = 6.0, p < 0.001). Conclusions: Access to contraception was curtailed during the COVID-19 pandemic, especially for those who experienced employment and financial instability. Individuals' and clinics' ability to mitigate these effects were likely dependent on state context and response to the pandemic, among other factors.