58. Persistent Social Disparities in Sexual and Reproductive Health Service Use Among Young U.S. Women

Purpose: We previously described declining trends and socioeconomic differentials in youngwomen’s use of sexual and reproductive health (SRH) services between 2002 and 2006 that disproportionately impacted young women of socioeconomic disadvantage and corresponded with negative trends and disparities in SRH outcomes. Here, we reexamine trends and socioeconomic determinants of use of SRH services among young U.S. women since. Methods: Data were drawn from the most recent The National Survey of Family Growth (NSFG) and collected continuously between 2006 to 2010 via household interviewswith 12,279 U.S. women ages 15-44 years. We focused on non-pregnant adolescent and young adult women (15–24 years) (n 4,360). Our final sample included 3,780 young women.Womenwere asked whether they had visited a medical provider for SRH care within the 12 months preceding the survey including contraceptive (contraceptive or emergency contraceptive method provision, follow-up evaluation, or counseling) and STI (testing or treatment). We used a 4-point indicator of the year in which the survey was administered between June 2006 and July 2010. Women were also asked about key demographic, social, economic and reproductive characteristics.We calculated estimates (weighted proportions; odds ratios with 95% confidence intervals) of SRH service use overall, among sexually experienced women, by service type and across sociodemographic characteristics using descriptive and bivariate statistics andmultivariable logistic regression models. We used survey weights and the SVY Stata 11.0 commands. Results: Overall, 55% of young women in 2006-2010 used SRH services, including contraceptive (45%) and STI (18%) services. Among sexually experienced women, 77% used SRH services, including contraceptive (64%) and STI (29%) services.SRH service use increased from50% in year 1 to 57% in year 4 (ORs 1.4, p values 0.03 for all years versus year 1). Among sexually experiencedwomen, though, proportionswere similar over time (74% year 1 to 78% all other years, p values 0.14). Contraceptive service use among sexually experienced women was also unchanged (ranging from 61% year 2 to 67% year 3, p values 0.20), while STI service use increased (22% year 1, 31% year 2(OR 1.6, p 0.02), 33% year 3(OR 1.7, p 0.009). Service use varied by women’s sociodemographic characteristics. Black women, older, college-educated and insured women, those with less frequent religious service participation, sexual experience,more sexual partners and gynecological problems had greater odds of using SRH services compared to their counterparts. Greater odds of contraceptive service use were noted amongWhite women, older, collegeeducated, rural-residing and insuredwomen, thosewithmore sexual partners and gynecological problems. For STI service use, greater odds were noted among older and urban-residing women, women from a disrupted childhood family situation and those with more sexual partners. Conclusions: Despite promising trends in young U.S. women’s use of SRH services in 2006-2010, disparities across sociodemographics groups continued to exist. Varying somewhat by service type, overall younger, socially disadvantaged and racial/ethnic minority women used services less than their counterparts. Further research is needed to determine the impact of the U.S. health care reform on trends and disparities in SRH service use and outcomes, particularly for adolescent women. SourcesofSupport:NIHNICHD#K12HD001438and#R24HD047879.