Oral

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. This session investigates four aspects of cross-border contraceptive access. The first paper looks at use of health services among clinic and pharmacy OC users and shows that although women in El Paso who choose OTC access to OCs report statistically significant lower use of preventive care, which includes pap smears, pelvic and breast exams, and screening for STI, the vast majority still obtain these services. The second presentation investigates knowledge regarding oral contraceptive use, risks and benefits among clinic and pharmacy users and the impact of written information. The analysis found that women who were clinic users, had completed high school, were US-born, and nulliparous were more likely to answer correctly. There was no improvement in knowledge among women given the leaflet. Future research should examine whether knowledge discrepancies impact quality of OC use. The third paper examines why women choose clinic or OTC oral contraceptives. Analysis showed that older women and those born and educated in Mexico were more likely to be pharmacy users. Cost, the availability of other services and not having to see a doctor for a prescription were motivating factors for obtaining OCs at pharmacies or clinics. Most women were very satisfied with both their pill source and brand. The fourth presentation about OC continuation and whether having a prescription matters found that OTC provision of OCs would not adversely affect continuation or pregnancy rates, and provide support for removing the medical requirements for obtaining oral contraception in the US. For clinic users, the results also support the recent finding that continuation can be improved by providing a larger number of pill cycles at clinic visits.

Session Objectives: • Describe the patterns of OC use among women in El Paso who choose to obtain their method in a US clinic or a Mexican pharmacy • 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 • Identify the topics related to OC use about which participants were knowledgeable and those about which they were less knowledgeable • Identify women’s motivations for choosing their source of OCs

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)