Navigating risk: Effect of counseling on contraception practice in urban Hispanic women with systemic lupus erythematosus.

Abstract

Objective: To examine the frequency of and associations among contraception counseling, contraception use, and the use of teratogenic medications in women of child-bearing age from the Hispanic Los Angeles systemic lupus erythematosus (SLE) population.

Methods: A 28-Question Anonymous Survey, Based on the 2020 American College of Rheumatology Reproductive Health Guideline, Was Distributed to 151 Female SLE Patients of Child-Bearing Age in the Outpatient Setting. Pearson χ² Test, Fisher Exact Test, and Wilcoxon Rank Sum Test Were Used, with Multivariable Analysis Conducted Via Logistic Regression.

Results: Contraception counseling significantly increased the likelihood of contraception use among sexually active patients on teratogenic medications (P = 0.009). However, no significant difference was found in the use of effective/highly effective contraception methods between patients on teratogenic medications and those not on them (P = 0.07). Spanish-speaking patients reported significantly less counseling in the past year compared with English-speaking patients (34.9% vs. 77.2%, P < 0.01), even after adjusting for age.

Conclusions: Many patients with SLE on teratogenic medications do not use appropriate contraception. Among this high-risk Hispanic SLE population, contraception counseling was associated with increased contraception use. However, Spanish-speaking patients reported lower rates of counseling compared with their English-speaking counterparts, highlighting a disparity that warrants further investigation.