Telemedicine for birth control feels difficult for young adults experiencing food and housing insecurity

The COVID-19 pandemic motivated healthcare providers to expand telemedicine to prevent spreading the virus. Telemedicine offers a safe and effective way to support people starting or continuing contraception. It can help increase access to care, especially for people in rural areas or underserved groups, by eliminating the need for transportation and childcare. However, research has found that these groups are less likely to use telemedicine.

A new study from Beyond the Pill looked at whether young adults who had trouble accessing basic needs like food and housing would feel like they could use telemedicine for birth control.

More than 1 in 5 of the young adults from California and Texas in the survey thought it would be difficult to have a telemedicine visit for birth control. People experiencing food or housing insecurity were significantly more likely to feel like it would be hard to have a telemedicine visit.

The most common barriers they cited were needing to have an in-person visit for their method, a lack of privacy at home, and lack of comfort with telemedicine. Technology-related barriers were less common, though still a challenge for many of them.

People experiencing food insecurity were significantly more likely to report each of the perceived barriers to video visits, except for their providers not offering telemedicine. For phone calls, they were more likely to say that they would need to get their method in person, would not feel comfortable with a phone visit, or that their insurance wouldn’t cover it. Young adults experiencing housing insecurity were more likely to report that they wouldn’t have the necessary device for a visit and would prefer in-person to a phone visit.

Many reported a lack of knowledge about telemedicine. About half didn’t know if their doctor or clinic offered video or phone visits, and more than one-third didn’t know if their insurance would cover telemedicine.

Providers should take steps to ensure equal access to telemedicine for contraception. Many young people expressed privacy concerns. Encouraging patients to wear headphones, using yes/no questions, and using chat functions on video platforms are examples of strategies for improving privacy. Outreach could increase knowledge of telemedicine, including which birth control methods require an in-person visit, and to build health literacy skills to enable young people to access and understand information about telemedicine. There’s more work to be done to identify best practices for youth-friendly telemedicine visits. At the same time, it’s critical to give young people a choice between telemedicine and an in-person visit, respecting individual preferences and acknowledging disparities in accessing telemedicine.