Table 2.
Weighted percentages, unadjusted and adjusted odds ratios from simple and multivariable logistic regression analyses assessing associations between selected access and experiences of sexual and reproductive health and sociodemographic characteristics and unfulfilled contraceptive preferences due to cost by contraceptive use status among lower income women aged 15 to 49, National Survey of Family Growth 2015–2019
| Unfulfilled contraceptive preferences due to cost among contraceptive users |
Unfulfilled contraceptive preferences due to cost among nonusers of contraception |
|||||||
|---|---|---|---|---|---|---|---|---|
| Users, N = 3178 |
Model 1, N = 3130 | Model 2a, N = 1020 | Nonusers, N = 1073 |
Model 1, N = 1054 | Model 2a, N = 166 | |||
| Weighted % | OR (95% CI) | aOR (95% CI) | aOR (95% CI) | Weighted % | OR (95% CI) | aOR (95% CI) | aOR (95% CI) | |
| Overall | 23% | 39% | ||||||
| Access and experiences of SRH | ||||||||
| Current method usedb | ||||||||
| LARC methods | 14% | 1.00 | 1.00 | 1.00 | ||||
| SARC methods | 18% | 1.28 (0.91, 1.78) | 1.46 (1.00, 2.13) | 1.05 (0.60, 1.82) | ||||
| Condom and other methods | 33% | 2.91 (2.04, 4.13) | 3.70 (2.51, 5.45) | 3.66 (1.96, 6.83) | ||||
| Source of SRH carec | ||||||||
| No SRH care | 26% | 1.00 | 1.00 | 33% | 1.00 | 1.00 | ||
| SRH but no contraceptive care | 24% | 0.89 (0.58, 1.37) | 0.81 (0.52, 1.27) | 35% | 1.08 (0.67, 1.77) | 1.26 (0.69, 2.32) | ||
| Private contraceptive-specific SRH care | 19% | 0.65 (0.46, 0.91) | 1.08 (0.72, 1.62) | 1.00 | 46% | 1.71 (0.97, 3.01) | 1.75 (0.92, 3.32) | 1.00 |
| Public contraceptive-specific SRH care | 30% | 1.20 (0.78, 1.83) | 1.58 (1.00, 2.50) | 1.46 (0.99, 2.16) | 60% | 3.06 (1.49, 6.26) | 2.21 (0.97, 5.05) | 0.54 (0.20, 1.41) |
| Current insurance coverage | ||||||||
| None | 35% | 1.00 | 1.00 | 1.00 | 45% | 1.00 | 1.00 | 1.00 |
| Private | 19% | 0.43 (0.31, 0.60) | 0.60 (0.41, 0.88) | 0.37 (0.16, 0.85) | 34% | 0.62 (0.37, 1.04) | 0.66 (0.36, 1.23) | 5.22 (0.94, 29.13) |
| Public | 24% | 0.57 (0.41, 0.80) | 0.69 (0.48, 0.99) | 0.53 (0.23, 1.19) | 42% | 0.88 (0.54, 1.41) | 0.81 (0.48, 1.35) | 1.68 (0.51, 5.59) |
| Composite patient-centered contraceptive counseling experienced | ||||||||
| No | 24% | 1.00 | 1.00 | 44% | 1.00 | 1.00 | ||
| Yes | 17% | 0.64 (0.42, 0.98) | 0.64 (0.40, 1.02) | 57% | 1.73 (0.73, 4.10) | 2.11 (0.77, 5.73) | ||
| Demographic characteristics | ||||||||
| Age | ||||||||
| 15–19 y | 20% | 0.98 (0.59, 1.61) | 1.37 (0.69, 2.69) | 3.77 (0.88, 16.20) | 57% | 2.88 (1.27, 6.54) | 2.71 (1.09, 6.76) | na |
| 20–29 y | 24% | 1.21 (0.77, 1.91) | 1.31 (0.79, 2.19) | 3.19 (0.90, 11.36) | 47% | 1.95 (1.09, 3.49) | 1.46 (0.82, 2.57) | 1.68 (0.33, 8.64) |
| 30–39 y | 22% | 1.10 (0.68, 1.80) | 1.15 (0.70, 1.89) | 2.58 (0.71, 9.35) | 31% | 0.97 (0.54, 1.72) | 0.78 (0.42, 1.47) | 1.26 (0.20, 7.84) |
| 40–49 y | 21% | 1.00 | 1.00 | 1.00 | 31% | 1.00 | 1.00 | 1.00 |
| Race/ethnicity | ||||||||
| White, non-Hispanic | 19% | 1.00 | 1.00 | 1.00 | 30% | 1.00 | 1.00 | 1.00 |
| Black, non-Hispanic | 22% | 1.20 (0.86, 1.69) | 0.97 (0.68, 1.37) | 0.65 (0.37, 1.15) | 40% | 1.55 (0.94, 2.56) | 1.26 (0.78, 2.04) | 0.59 (0.13, 2.59) |
| Other/multiple, non-Hispanic | 21% | 1.16 (0.72, 1.86) | 0.93 (0.57, 1.51) | 1.53 (0.79, 2.98) | 45% | 1.86 (0.83, 4.13) | 1.99 (0.92, 4.32) | 4.24 (0.86, 20.80) |
| Hispanic | 31% | 1.97 (1.37, 2.84) | 1.52 (0.98, 2.35) | 1.61 (0.82, 3.19) | 52% | 2.53 (1.53, 4.18) | 2.77 (1.61, 4.77) | 2.31 (0.58, 9.18) |
| Federal poverty level | ||||||||
| 0%–99% | 25% | 1.39 (1.00, 1.92) | 1.18 (0.83, 1.66) | 1.02 (0.48, 2.19) | 41% | 0.96 (0.56, 1.64) | 0.56 (0.31, 1.03) | 0.34 (0.10, 1.13) |
| 100%–199% | 24% | 1.30 (0.94, 1.79) | 1.12 (0.79, 1.58) | 0.80 (0.42, 1.51) | 36% | 0.81 (0.47, 1.38) | 0.65 (0.38, 1.12) | 0.79 (0.24, 2.60) |
| 200%–299% | 19% | 1.00 | 1.00 | 1.00 | 42% | 1.00 | 1.00 | 1.00 |
| Nativity status | ||||||||
| US born | 21% | 1.00 | 1.00 | 1.00 | 39% | 1.00 | 1.00 | 1.00 |
| Foreign born | 32% | 1.79 (1.37, 2.34) | 1.41 (0.96, 2.08) | 1.77 (0.87, 3.63) | 39% | 0.98 (0.60, 1.61) | 0.72 (0.40, 1.29) | 1.25 (0.38, 4.11) |
| Relationship status | ||||||||
| Married | 20% | 1.00 | 1.00 | 1.00 | 30% | 1.00 | 1.00 | 1.00 |
| Cohabitating | 26% | 1.40 (0.96, 2.05) | 1.46 (0.97, 2.19) | 0.68 (0.30, 1.53) | 38% | 1.43 (0.83, 2.49) | 1.23 (0.68, 2.24) | 1.82 (0.41, 8.03) |
| Not married or cohabitating | 23% | 1.19 (0.88, 1.60) | 1.61 (1.11, 2.34) | 2.00 (0.90, 4.44) | 46% | 2.04 (1.36, 3.07) | 1.55 (0.92, 2.61) | 3.96 (1.34, 11.74) |
| Educational attainment | ||||||||
| Not a high school graduate | 25% | 1.00 | 1.00 | 1.00 | 47% | 1.00 | 1.00 | 1.00 |
| High school graduate/GED | 24% | 0.93 (0.67, 1.29) | 1.09 (0.78, 1.54) | 0.88 (0.47, 1.66) | 42% | 0.81 (0.48, 1.36) | 1.00 (0.58, 1.72) | 1.00 (0.21, 4.65) |
| Some college | 22% | 0.83 (0.58, 1.20) | 1.11 (0.74, 1.68) | 1.43 (0.83, 2.48) | 36% | 0.63 (0.38, 1.02) | 0.83 (0.47, 1.46) | 2.13 (0.29, 15.82) |
| College graduate | 20% | 0.74 (0.47, 1.15) | 1.14 (0.67, 1.95) | 1.05 (0.42, 2.67) | 33% | 0.54 (0.31, 0.95) | 0.91 (0.49, 1.69) | 0.17 (0.01, 2.02) |
| Parity | ||||||||
| 0 | 21% | 1.00 | 1.00 | 1.00 | 38% | 1.00 | 1.00 | 1.00 |
| 1 or more | 24% | 1.15 (0.91, 1.46) | 1.28 (0.92, 1.77) | 1.70 (0.89, 3.26) | 40% | 1.04 (0.71, 1.54) | 1.81 (1.11, 2.97) | 1.88 (0.43, 8.29) |
| Sexual identity | ||||||||
| Straight | 22% | 1.00 | 1.00 | 1.00 | 38% | 1.00 | 1.00 | 1.00 |
| Not straight | 26% | 1.22 (0.85, 1.75) | 1.18 (0.82, 1.72) | 0.83 (0.44, 1.59) | 49% | 1.52 (0.88, 2.63) | 1.45 (0.77, 2.72) | 0.50 (0.13, 1.93) |
OR, odds ratio; CI, confidence interval; aOR, adjusted odds ratio; na, not available due to insufficient cell size; SRH, sexual and reproductive health; NSFG, National Survey of Family Growth; LARC, long-acting reversible methods; SARC, short-acting reversible methods; FPL, federal poverty level; IUD, intrauterine device; STI, sexually transmitted infection; PCCC, patient-centered contraceptive counseling.
Population includes all female respondents aged 15 to 49 at the time of interview who were under 300% of the FPL and who responded to the unfulfilled contraceptive preferences due to cost variables; population is weighted to reflect the female civilian population of the United States. Population excludes those who were sterile and whose partner was sterile for non-contraceptive purposes; those who used permanent methods such as tubal ligation, hysterectomy, or vasectomy as their most effective method; those who were not using any method of contraception and did not have a male sexual partner in the past 12 months; and those who were not using any method of contraception and were actively trying to become pregnant as a reason for not using contraception.
Bold font indicates ORs and aORs significant at or close to, the p < 0.05 level.
Models 2 are limited to those respondents who received contraceptive care in past 12 months and only include respondents from the 2017–2019 NSFG data.
LARC methods include IUDs and hormonal implants (Norplant, Implanon, or Nexplanon). SARC methods include pills, Depo-Provera and other injectables, the contraceptive patch (Ortho-Evra or Xulane), and the vaginal contraceptive ring. Other methods include noncondom coital methods such as withdrawal, the diaphragm, foam, jelly or cream, and emergency contraception; natural family planning methods such as periodic abstinence, cervical mucus tests, temperature rhythm, or calendar rhythm; and other non-specified methods.
Source of SRH care categorizes the clinic where the respondents received certain kinds of care in the past 12 months. This includes gynecologic care, pregnancy care, STI care and contraceptive care. Contraceptive care includes contraceptive methods, contraceptive counseling, or a check-up related to contraceptive use.
The composite PCCC measure combines all 4 patient-centered care items to create a dichotomous variable that considered those who rated their provider as “excellent” on all 4 characteristics to have received patient-centered contraceptive counseling, while those who rated their provider as anything less than “excellent” on any 1 of the 4 characteristics were considered to have not.