Perceptions of oral contraception safety and interest in over-the-counter access among a predominantly Latina population in Texas

Fear of side effects and previous negative experiences are common reasons for contraceptive non-use. We collected information about contraceptive use and perceptions of oral contraceptive (OC) safety from 1,271 women 18-49 years old recruited at malls in El Paso, Texas, to better understand factors associated with safety perceptions. Methods used included 19.9% hormonals, 11.2% non-hormonals, 2.8% IUD, 27.5% sterilization, and 38.7% used no method. Older and parous women were more likely to use the IUD or sterilization, and Spanish-speakers more likely to use no method compared to hormonals (p<0.05). Among women not using combined-hormonal methods (n=1,056), only 42.7% said OCs were medically safe for them. Reasons given for OCs being unsafe related to fears of side effects and prior negative experiences rather than true contraindications. Young and more educated women and those recruited in a more wealthy area were more likely to think OCs were safe, while Spanish-speakers were more likely to think them unsafe (p<0.05). Among non-users or non-hormonal users and potential OC candidates (n=601), 60.2% said they would be more likely to use OCs if they were available over-the-counter (OTC). In regression analysis, OTC interest was higher among non-contraceptive-users (p<0.05), those recruited at the more wealthy site (p<0.05), and young women (p=0.05). Despite the negative perceptions of OC safety in this population, interest in OTC access was high. More education about the safety and health benefits of hormonal contraception is needed. OTC availability might contribute to more positive safety perceptions of OCs compared to a prescription environment.