223099 Use of oral contraceptives among hypertensive Latinas on the Texas-Mexico border

Tuesday, November 9, 2010 : 1:10 PM - 1:30 PM

Diana Lara, MD, MS , Ibis Reproductive Health, Oakland, CA
Daniel Grossman, MD , Ibis Reproductive Health, Oakland, CA
Georgina Martinez, MS , Departamento de Ciencias Sociales, Universidad Autónoma de Ciudad Juárez, Ciudad Juarez, Mexico
Alma Hernandez, Graduate Student , Border Contraceptive Access Study, University of Texas at El Paso, El Paso, TX
Jon Amastae, PhD , Center for Inter-American and Border Studies, University of Texas at El Paso, El Paso, TX
Hypertension is a contraindication to combined oral contraceptive (COC) use. Among 1,046 oral contraceptive (OC) users in El Paso, Texas, we found approximately 8% were hypertensive. Many were unaware of having hypertension regardless of whether they obtained pills in US clinics or Mexican pharmacies. We aimed to explore barriers to detection and control of hypertension, motivations to continue using OCs among hypertensive OC users, and barriers to access more appropriate contraception.

This study is part of the Border Contraceptive Access Study (BCAS), which recruited 532 El Paso residents who obtained OCs at clinics and 514 El Paso residents who obtained OCs over-the-counter at Mexican pharmacies. We conducted 31 interviews with hypertensive BCAS study participants and 12 with hypertensive COC users who were residents of Ciudad Juarez, Mexico, recruited through local community organizations.

Only seven women were aware of cardiovascular risks associated with taking COCs when hypertensive. Most women checked their blood pressure regularly, although more El Paso residents obtaining pills at Mexican pharmacies said they did not. Mexico residents were better informed about the range of contraceptive options than El Paso residents. Frequently mentioned barriers to switching to other contraceptives were the high cost of sterilization and IUDs, long waiting times for sterilization, and fear of side effects and lack of availability of other methods.

Interventions to inform border residents about risks of hypertensive women taking COCs and widespread blood pressure screening are necessary, as well as efforts to increase the availability of other contraceptives in US and Mexican clinics.

Learning Areas:
Assessment of individual and community needs for health education
Chronic disease management and prevention
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related education
Public health or related public policy

Learning Objectives:
• List the structural and cultural barriers that Mexican and Mexican American border residents face to information, early detection and control of hypertension. • Compare the differences in information and control of hypertension of women who get their OCs at clinics vs. those who accessed OCs over-the-counter at pharmacies in Mexico, and those who are Ciudad Juarez residents vs. El Paso residents. • Describe the factors associated with use of OC among hypertensive women including motivations to continue using OCs and barriers to access to more appropriate contraceptive methods among El Paso and Ciudad Juarez residents • Identify the unique phenomenon of health access in the U.S. -Mexico border where two systems of healthcare delivery meet, and their differences in regulation and provision of pharmaceuticals have created options for area residents not available elsewhere.

Keywords: Contraceptives, Hypertension

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I was part of the research team that conducted and supervised field work, analyzed data and wrote a report of this study.
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.