ASSOCIATION BETWEEN EXPERIENCES OF DISCRIMINATION AND CONCERNS ABOUT ACCESSING CONTRACEPTIVE CARE AMONG COMMUNITY COLLEGE STUDENTS IN TEXAS AND CALIFORNIA

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2024-10-07 DOI:10.1016/j.contraception.2024.110640

LA Tello Perez, J Yarger, HK Hecht, K Hopkins, I Rossetto, C Harper

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引用次数: 0

Abstract

Objectives

We aimed to identify whether experiences of discrimination are associated with students’ concerns about accessing contraception.

Methods

We analyzed baseline data (n=2,086) from an ongoing cluster randomized trial in Texas and California with sexually active community college students aged 18-25, assigned female at birth (gender- inclusive). Experiences of Discrimination (EOD) were measured using a validated and reliable scale (α = 0.8). We examined the association between EOD and concerns about being judged or disrespected by a medical provider, and whether the student felt comfortable discussing contraception with a provider. We used mixed effects logistic regression for clustered data, controlling for key sociodemographic factors.

Results

Overall, 21% of participants reported concerns about being judged or disrespected, and 17% reported feeling uncomfortable discussing contraception. EOD positively correlated with concerns about judgment or disrespect (adjusted OR (aOR)=1.13, CI 95% 1.09-1.16) and discomfort discussing contraception (aOR=1.04, CI 95% 1.01-1.08). Asian/Pacific Islanders had higher odds of worrying about judgment/disrespect (aOR=1.95, CI 95% 1.28-2.99) and discomfort discussing contraception (aOR=1.99, CI 95% 1.25-3.16) compared to White students. Latinx students also had higher odds of discomfort discussing contraception (aOR=1.52, CI 95% 1.04-2.23) as did first-generation college students (aOR=1.37, CI 95% 1.04-1.80). Finally, not speaking English at home was associated with concerns about judgment or disrespect (aOR=1.31, CI 95% 1.01-1.70).

Conclusions

Experiences of discrimination are associated with concerns about being judged or disrespected, as well as discomfort discussing contraception with providers. Healthcare providers and institutions should recognize and work to reduce the impact of discrimination on patients, particularly among young and marginalized patient communities.

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德克萨斯州和加利福尼亚州社区大学生遭受歧视的经历与对获得避孕护理的担忧之间的联系

方法我们分析了德克萨斯州和加利福尼亚州正在进行的群组随机试验的基线数据（n=2,086），这些数据来自 18-25 岁的性活跃社区大学生，他们出生时被分配为女性（包括性别）。歧视经历（EOD）采用经过验证的可靠量表进行测量（α = 0.8）。我们研究了 EOD 与担心被医疗服务提供者评判或不尊重以及学生是否愿意与医疗服务提供者讨论避孕问题之间的关联。我们使用混合效应逻辑回归法对聚类数据进行分析，并对主要社会人口学因素进行了控制。结果总体而言，21% 的参与者表示担心受到评判或不尊重，17% 的参与者表示在讨论避孕问题时感到不自在。EOD 与担心被评判或不被尊重（调整 OR (aOR)=1.13, CI 95% 1.09-1.16）和讨论避孕问题时感到不适（aOR=1.04, CI 95% 1.01-1.08）呈正相关。与白人学生相比，亚太裔学生担心被评判/不尊重（aOR=1.95，CI 95% 1.28-2.99）和在讨论避孕问题时感到不适（aOR=1.99，CI 95% 1.25-3.16）的几率更高。拉美裔学生与第一代大学生（aOR=1.37，CI 95% 1.04-1.80）相比，在讨论避孕问题时感到不适的几率也更高（aOR=1.52，CI 95% 1.04-2.23）。最后，在家不说英语与担心被评判或不被尊重有关（aOR=1.31，CI 95% 1.01-1.70）。医疗服务提供者和医疗机构应认识到并努力减少歧视对患者的影响，尤其是对年轻和边缘化患者群体的影响。

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.