Perspectives on Sexual and Reproductive Health最新文献

{"title":"The Association Between Distance Traveled for Abortion Care and Abortion Stigma in the Urban Midwest of the United States, 2020.","authors":"Carly Dahl, Ashish Premkumar, Amanda Allshouse, Ashley Turner, Cayla Bales, Lindsay Cheu, Sunayna Wahi, Avni Singh, Allison Cowett, Leanne McCloskey, Michelle Debbink","doi":"10.1111/psrh.70087","DOIUrl":"https://doi.org/10.1111/psrh.70087","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between distance traveled for abortion care and abortion stigma in an urban, unrestricted area in the pre-Dobbs versus Jackson Women's Health Organization (Dobbs) era in the Midwest of the United States.</p><p><strong>Study design: </strong>We performed a cross-sectional survey of patients seeking abortion care in Chicago, Illinois between July and December 2020. Participants provided information about their commute and residential zip code and completed the Individual Level Abortion Stigma Scale (ILASS). The primary exposure was distance traveled in miles to the clinic. The primary outcome was ILASS total score (range 0-3.5). We used adjusted linear regression to evaluate the association between distance traveled and ILASS total score and subscales.</p><p><strong>Results: </strong>Among 500 participants, the average gestational duration was 8 weeks and 6 days. Individuals traveling farther had a higher gestational duration at the time of the abortion (9 weeks and 2 days versus 8 weeks and 2 days, p = 0.02). Among participants traveling <math><mrow><mo>≤</mo></mrow> </math>  50 miles, the median ILASS score was lower (0.85, 95% CI 0.79-0.90) than those traveling > 50 miles (1.05, 95% CI 0.89-1.21) (p = 0.01). In adjusted regression models, traveling > 50 miles (β 0.19, 95% CI 0.04-0.34) remained associated with an increased ILASS score, which was driven by judgment (from others) and community condemnation subscales.</p><p><strong>Conclusion: </strong>We found that traveling > 50 miles to obtain abortion care was independently associated with higher individual-level abortion stigma scores in the pre-Dobbs era Midwest.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148913804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bleeding and Cramping in the First 90 Days After Copper or Levonorgestrel Intrauterine Device Placement.","authors":"Siripanth Nippita, Anna Merport Modest, Carolyn L Westhoff, Paula M Castaño, Johana Oviedo, Katherine Rivlin","doi":"10.1111/psrh.70088","DOIUrl":"https://doi.org/10.1111/psrh.70088","url":null,"abstract":"<p><strong>Introduction: </strong>We describe bleeding and cramping patterns during the first 90 days after intrauterine device (IUD) placement.</p><p><strong>Methods: </strong>This was a planned sub-analysis of a prospective cohort study of IUD users in the United States who initiated the copper T380A (Cu-IUD) or the levonorgestrel 52 mg intrauterine device (LNG IUD) at any time in the menstrual cycle. Participants rated bleeding and cramping from 1 (no bleeding or cramping) to 4 (heavy bleeding or severe cramping). We included participants providing ≥ 60 days of continuous responses and described overall bleeding/cramping.</p><p><strong>Results: </strong>Of 230 participants enrolled, 137 (60%) met inclusion criteria (Cu-IUD n = 69, 50% and LNG IUD n = 68, 50%). Cu-IUD users reported fewer days with any bleeding (26 days, IQR 18-31) compared with LNG IUD users (38 days, IQR 27-55, p < 0.001). LNG IUD users reported more spotting days (median 31 [IQR 17-41] vs. 13 [IQR 10-20], p < 0.01). Total bleeding/spotting days were similar for each IUD type regardless of placement timing or prior contraceptive method. Median reported cramping days were similar for both IUDs (Cu-IUD 18, IQR 7-29 and LNG IUD 18, IQR 10-38, p = 0.18). Cramping was most common in the week following placement for both IUD types, decreased over the 90-day period, and did not vary by IUD type.</p><p><strong>Conclusion: </strong>LNG IUD users reported more days with any bleeding in the first 90 days after placement overall compared with Cu-IUD users, largely driven by more than twice the number of spotting days. Cramping was most common in the first week following IUD placement and decreased over time.</p><p><strong>Trial registration: </strong>Clinicaltrials.Gov Identifier: NCT01730911.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Differences in Sexually Active Life Expectancy in France.","authors":"Caroline Moreau, Lena Pamboutzoglou, Antoine Sireyjol, Nathalie Bajos","doi":"10.1111/psrh.70076","DOIUrl":"https://doi.org/10.1111/psrh.70076","url":null,"abstract":"<p><strong>Introduction: </strong>A life course perspective on sexual activity is gaining attention due to increased longevity and the relationship between health and sexual behavior. Building on Lindau's and Gavrilova's concept of sexually active life expectancy, we examine how including non-partnered sexual behaviors and satisfaction influences sexual life expectancy by gender in France.</p><p><strong>Methods: </strong>We estimate sexually active life expectancy using Sullivan's method, which integrates life table data from the 2023 vital registration with sexual activity prevalence from the CSF-2023 French national survey. We also calculate a quality-adjusted sexually active life expectancy that accounts for sexual satisfaction. Finally, we identify sociodemographic and health factors related to having a satisfying sexual activite life among individuals aged 50-89.</p><p><strong>Results: </strong>A 20-24-year-old man has a sexually active life expectancy of 47.1 years, compared to 44.5 years for a woman. This figure expands to 52.9 years for men and 48.9 years for women when including masturbation. The gender gap narrows when considering sexual satisfaction, with men losing 11 years and women 8 years of sexual life expectancy due to poor sexual satisfaction. Among individuals aged 50-89, the gender gap in being sexually active and satisfied narrows from OR = 0.64 [0.57-0.72] after adjusting for age to OR = 0.76 [0.67-0.87] after further adjustments for partnership status, health, and sociodemographics.</p><p><strong>Conclusion: </strong>This study enhances population-level indicators of sexual health by broadening the understanding of sexuality beyond partnered behaviors. It reveals significant gender differences in sexual experiences throughout the life course, which lessen when considering sexual quality.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Intra-Amniotic and Intra-Fetal Digoxin Administration in Late Second-Trimester Abortion by Dilation and Evacuation.","authors":"Eleanor A Drey, Nora Goldschlager, Neal L Benowitz, Abby Sokoloff, Rebecca A Jackson","doi":"10.1111/psrh.70081","DOIUrl":"https://doi.org/10.1111/psrh.70081","url":null,"abstract":"<p><strong>Objective: </strong>The study's purpose was to determine the safety of two routes and doses of digoxin through assessment of systemic absorption, cardiac rhythm, and coagulation parameters injected as part of second-trimester dilation and evacuation abortion.</p><p><strong>Methods: </strong>We randomized pregnant women between 19 and 23 weeks' gestation to receive either 1.5 mg digoxin through intra-amniotic injection (IAI) or 1.0 mg through intrathoracic injection (IFI). We measured subjects' serum digoxin levels and coagulation indices over 48 h post-injection and cardiac rhythm monitoring for 24 h.</p><p><strong>Results: </strong>Ten patients in each group completed the study. All injections caused fetal demise within 24 h. In the IAI group, mean (±SD) digoxin peak concentration in the IAI group was 1.5. ±0.72 (range 0.7-2.9 ng/mL); in the IFI group 1.4 ± 0.74 ng/mL (range 0.5-2.4 ng/mL). Mean (±SD) time to peak digoxin level in the IAI group was 10.7 ± 8.5 h (range, 1-24 h); in the IFI group 1.5 ± 0.97 h (range, 1-4 h, p < 0.01). Five patients had laboratory-defined critical digoxin levels of uncertain significance. Cardiac rhythm monitoring showed no digoxin-associated rhythm or conduction abnormalities. Prothrombin and partial thromboplastin time levels remained normal in both groups.</p><p><strong>Conclusion: </strong>Neither 1.5 mg IAI nor 1.0 mg IFI of digoxin administered to induce fetal demise was associated with adverse maternal cardiac outcomes or coagulation parameter changes. Serum levels reflected significant digoxin absorption in both groups, generally resulting in maximum digoxin concentration peaks in the low therapeutic range. Injecting digoxin to cause fetal demise in abortion care appears safe and effective.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Sexual Practices, Consensual and Non-Consensual Experiences and Wellbeing Consequences in the CSF-2023 French National Survey.","authors":"Armelle Andro, Rim Bellamine, Aline Bohet","doi":"10.1111/psrh.70084","DOIUrl":"https://doi.org/10.1111/psrh.70084","url":null,"abstract":"<p><strong>Introduction: </strong>Digital technologies have reshaped relationships and sexual practices, both in terms of sexual well-being and through the emergence of cyberharassment. However, evidence remains limited, however, on how these practices vary by gender, generation, sexual orientation, and social position. This article aims to describe the frequency of online sexual experiences and their correlates in a large national sample.</p><p><strong>Methods: </strong>The study draws on CSF-2023, a cross-sectional survey of sexuality in France. The sample comprises 15,906 individuals aged 18-59 who reported information on their online practices. We analyze the frequency of these experiences and their associations with gender, generation, sexual orientation, and educational level, using univariate and multivariate analyses.</p><p><strong>Results: </strong>Men reported online sexual experiences more often than women (58% vs. 46%). Sending intimate images was reported by 21% of women and 25% of men, and receiving them by 28% and 33% respectively. These practices were more frequent among younger respondents and among people who had same-sex partners, with older generations having taken them up later in life. A marked gender contrast emerged for negative experiences: while they affected 19% of women and 17% of men aged 18-59, the gap widened sharply among 18-29-year-olds (33% of women vs. 25% of men). Single women and people in poor health were more exposed; among men, risk was highest for those who had same-sex partners and a low level of education.</p><p><strong>Conclusion: </strong>Digital practices can be positive, but they can also lead to harmful exposure with deleterious effects, which particularly affect young women. There is a need to develop lifelong education about these new forms of intimate exchange, together with support measures for people confronted with these new forms of sexual violence.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Are We Allowed to Refer Patients?\": U.S. Physician Experiences Facilitating Abortion Care in a Restricted State.","authors":"Corinne M Hale, Laura Jacques, Eliza Bennett, Jenny A Higgins, Abigail S Cutler","doi":"10.1111/psrh.70073","DOIUrl":"https://doi.org/10.1111/psrh.70073","url":null,"abstract":"<p><strong>Objective: </strong>Few studies have examined how abortion referrals occur in settings that criminalize or restrict most abortion care. We aimed to document how Wisconsin obstetrician-gynecologists (OB-GYNs) facilitated abortion care for patients while practicing under the threat of a criminal ban following the elimination of federal abortion rights protection.</p><p><strong>Methods: </strong>We recruited 21 OB-GYNs from diverse practice settings in virtual interviews between September and December of 2023. Interviews explored experiences providing pregnancy care and facilitating abortion under institutional policies both before and following threatened enforcement of a state criminal abortion law. Investigators coded and analyzed data using a combined inductive-deductive approach.</p><p><strong>Results: </strong>We identified three themes regarding how Wisconsin OB-GYNs facilitated abortion under a statewide ban. First, physicians faced legal fog and lack of institutional guidance, leading to highly varied referral practices. Second, the lack of robust referral pathways had negative impacts for both physicians and patients. Third, many physicians were left to patch together their own abortion referral systems, leading to unique physician burdens.</p><p><strong>Conclusions: </strong>While abortion services were unavailable, Wisconsin's systems to facilitate abortion for patients were inadequate or absent, leaving OB-GYNs with informal and unconventional means to help patients access care within-and across-state lines. In settings where abortion is banned or severely restricted, referrals may rely heavily on healthcare institutional-level referral pathways and patient navigation systems. In such settings, institutions should help facilitate timely abortion access for patients and ease burdens on physicians by establishing and supporting robust referral systems and patient-centered navigation services.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodology of the French National Study \"Context of Sexualities in France\" (CSF-2023).","authors":"Caroline Moreau, Aline Bohet, Armelle Andro, Yann Le Strat, Nathalie Bajos","doi":"10.1111/psrh.70071","DOIUrl":"https://doi.org/10.1111/psrh.70071","url":null,"abstract":"<p><strong>Introduction: </strong>The 2023 national survey \"Context of Sexualities in France\" (CSF-2023) explores sexuality and sexual health in France.</p><p><strong>Methods: </strong>Conducted between November 2022 and December 2023, CSF-2023 is a cross-sectional probability survey involving 21,259 respondents aged 15-89 in continental France. Participants were selected via random-digit dialing, completing a 33-min phone interview (Part 1), followed by a 30-min self-administered online questionnaire for those 18 and older (Part 2). Sexually active respondents aged 18-59 also participated in a sexually transmitted infection (STI) self-testing study. The survey collected data on sociodemographic characteristics, sexual attitudes, relationships, practices, gender expressions, and digital use for self-care and sexual practices.</p><p><strong>Results: </strong>A total of 21,259 individuals completed the Part 1 survey (34% response rate). Of those, 12,906 individuals aged 18-89 completed Part 2 (71% of the 18-89 eligible group). Among the 13,686 individuals aged 18-59 offered STI testing, 4872 (32%) returned results; of the 2959 aged 18-29 offered Human Papillomavirus (HPV) testing, 811 (27%) participated. Post-stratification weights were applied to mitigate non-response bias for key sociodemographic traits, with minimal impact on sexual and reproductive health (SRH) indicators, reaffirming sample representativeness. Fieldwork highlighted the importance of not only adapting questionnaire design and sequencing, but also providing strong psychological and supervisory support to interviewers administering a large-scale survey on sensitive and sometimes distressing topics.</p><p><strong>Conclusion: </strong>CSF-2023 provides rich data to track trends in sexuality and sexual health in France, while expanding knowledge on emerging topics such as digital sexual health and SRH self-care. These findings can inform policy and programming, including the French National Strategy for Sexual Health and the World Health Organization European action plan for SRH. In parallel, the CSF-2023 fieldwork experience provides important methodological insights into the conduct of large-scale sexual health research, underscoring the central role of interviewer training, supervision, and psychological support in ensuring high-quality data collection on sensitive topics.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticipated Negative Impact of Dobbs v. Jackson Women's Health Organization Among Young Adult Black Women in the US.","authors":"Aaliyah Gray, Shelly Sinclair, Mary Jo Trepka, Kimberly M Nelson","doi":"10.1111/psrh.70080","DOIUrl":"10.1111/psrh.70080","url":null,"abstract":"<p><strong>Purpose: </strong>The United States Supreme Court case Dobbs v. Jackson Women's Health Organization overruled federal protections for abortion in 2022. Young adult Black women (YABW) are expected to be among those most impacted directly by abortion restrictions and indirectly by effects on broader sexual and reproductive health access. This study assessed the extent to which this population anticipates negative impacts of the ruling.</p><p><strong>Methods: </strong>A nationwide convenience sample of 500 YABW 18-22 years participated in an online sexual and reproductive health survey in November-December 2023. Participants rated the extent to which they anticipated negative impacts of Dobbs on five domains: their sex life and decisions related to prescription contraception, emergency contraception, sexually transmitted infection testing, and abortion. We used multivariable analyses including ordinal logistic regression to examine participant characteristics associated with anticipated negative impacts.</p><p><strong>Results: </strong>Half of participants (51%-59%) anticipated at least some negative impact of the Dobbs ruling across the five domains, and 19% reported high levels of anticipated negative impact. Greater odds of a high anticipated impact score were associated with awareness of the Supreme Court decision prior to participation (aOR = 2.00, 95% CI [1.09-3.83]) and medical mistrust (aOR = 1.71, 95% CI [1.22-2.40]).</p><p><strong>Discussion: </strong>These findings can inform the development of targeted support for YABW in the post-Dobbs landscape, which may include education on reproductive care options that remain legally available and culturally responsive care that fosters patient trust in the health care system within the current policy environment.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical Trends in Sexual Activity and Sexual Health in France (1992-2023): A Gendered Perspective.","authors":"Nathalie Bajos, Michel Bozon, Rim Bellamine, Armelle Andro","doi":"10.1111/psrh.70078","DOIUrl":"10.1111/psrh.70078","url":null,"abstract":"<p><strong>Objective: </strong>To analyze historical gender trends in sexual indicators in France over a period of three decades.</p><p><strong>Methods: </strong>We used data from three national probability surveys on sexual behaviors in France conducted in 1992 (N = 20,055), 2006 (N = 12,364), and 2023 (N = 19,015) to compare sexual indicators among men and women aged 18-69 years.</p><p><strong>Results: </strong>The median age at first sexual intercourse has increased since the late 2010s, reaching 18.2 years for women and 17.7 years for men in 2023. The average number of lifetime sexual partners for those who have already had a sexual partner increased from 3.4 in 1992, to 4.5 in 2006, to 8.0 in 2023 for women and from 11.2 in 1992, to 11.9 in 2006, and to 16.6 in 2023 for men. Meeting sexual partners online has become widespread, with 44% of women and 48% of men aged 18-29 doing so in 2023. The prevalence of same-sex partners also increased, from 3% in 1992 to 4% in 2006 to 10% in 2023 for women and from 4% in 1992 and 2006 to 9% in 2023 for men. Sexual activity in the past year and the frequency of sexual intercourse in the last 4 weeks decreased among single respondents since the 2000s. Meanwhile, having multiple partners and having masturbated increased, especially among women.</p><p><strong>Conclusion: </strong>These changes, which reflect increases in women's sexual agency and may partly be attributed to the digital revolution, need to be considered when tailoring public health messages to these new realities.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148833590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferred Medication Abortion Support in the Southeastern United States, 2024-2025: A Discrete Choice Experiment.","authors":"Hannah H Leslie, Dee Nelson, Valencia Robinson, Madeline Griffith, Kelsey Holt","doi":"10.1111/psrh.70083","DOIUrl":"https://doi.org/10.1111/psrh.70083","url":null,"abstract":"<p><strong>Introduction: </strong>Medication abortion use is increasing in the United States following policy and legal changes since 2021. Multiple service options exist within and outside of the US health system, but limited evidence addresses individuals' preferences for medication abortion services and support.</p><p><strong>Methods: </strong>We designed a discrete choice experiment with four attributes and accompanying levels: source of pills (\"telehealth visit,\" \"online order,\" \"community network\"), out-of-pocket cost ($0-$150), information support (\"information sheet,\" \"hotline,\" in-person \"clinic consult,\" in-person \"doula\"), and material support (none, \"essential care package,\" \"self-care package\"). We recruited pregnancy-capable individuals aged 18-45 in the southeastern United States using in-person community-based sampling in Mississippi and an online survey in Alabama, Georgia, Louisiana, and Mississippi from August 2024 to August 2025. We used Hierarchical Bayes modeling and simulations to quantify preferences.</p><p><strong>Results: </strong>We analyzed 215 respondents in Mississippi and 476 across the four-state sample. Respondents strongly preferred lower out-of-pocket cost followed by material support of an essential or self-care package. Preferences for information support and source of pills were weaker and differed by sample. In-person respondents preferred a community network as source and/or a doula for information support. Participants in the four-state sample preferred a telehealth visit or online order with a clinic consult. Interest in preferred options was high when out-of-pocket costs were below $50.</p><p><strong>Conclusions: </strong>Out-of-pocket cost was the highest priority and source of pills the lowest; participants valued inclusion of a care package and interactive information support in different forms. These findings can inform medication abortion services.</p>","PeriodicalId":47632,"journal":{"name":"Perspectives on Sexual and Reproductive Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}