201409 Use of health services among clinic and pharmacy oral contraceptive users in El Paso, Texas

Wednesday, November 11, 2009: 8:30 AM

Kristine Hopkins, PhD , Population Research Center, University of Texas at Austin, Austin, TX
Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
Kari White, MA, MPH , Department of Sociology, Population Research Center, University of Texas-Austin, Austin, TX
Jon Amastae, PhD , Center for Inter-American and Border Studies, University of Texas at El Paso, El Paso, TX
Joseph E. Potter, PhD , Population Research Center, University of Texas at Austin, Austin, TX
In Mexico, oral contraceptives (OCs) are available from pharmacies without a prescription, while in the US a prescription is required. The Border Contraceptive Access Study aims to understand contraceptive use among women in El Paso, Texas, who have the option to obtain OCs over-the-counter (OTC) at Mexican pharmacies or at US public clinics. In the debate regarding OTC access, some argue women will be less likely to obtain necessary preventive care if not required to visit a clinician to obtain OCs.

This analysis speaks to this debate by looking at experiences with health care visits among 533 clinic and 515 pharmacy users in El Paso.

Women reported relatively low levels of a usual source of care (62% for clinic, 68% for pharmacy). The majority of clinic users (98.7%) and pharmacy users (89.4%) reported Pap screening in the past three years, and 99.6% and 96.9% reported ever having a Pap smear. In adjusted logistic regression models, clinic users and parous women had significantly higher odds of ever having Pap screening and being screened in the past 3 years (p<0.001). Clinic users and parous women also had higher adjusted odds of ever having a pelvic (p<0.01) or breast exam (p<0.001) or screening for STIs (p<0.01).

Although women in El Paso who choose OTC access to OCs report statistically significant lower use of preventive care, the vast majority still obtain these services. The findings suggest that OTC access does not reduce preventive screening in a clinically significant degree.

Learning Objectives:
1. Describe the different patterns of health care visits between women who receive oral contraceptives from US family planning clinics versus those who obtain pills over-the-counter at Mexican pharmacies 2. List the factors associated with obtaining preventive health services in the two groups 3. Discuss the relevance of these findings to the potential availability of hormonal contraception over-the-counter in the US

Keywords: Contraceptives, Hispanic

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Co-investigator on Border Contraceptive Access Study. PhD in demography/sociology with over 10 years experience studying contraceptive use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.