LAUSR

Objectives: To examine disparities in access to telemedicine visits for contraception during the COVID-19 pandemic by young people's experiences of basic needs insecurity. Methods: We collected data from May 2020 to March 2021 from people at risk of pregnancy aged 18–28 in an ongoing study of community college students in California and Texas (n=1,352). Multivariate logistic regression analyses, adjusted for clustering by site, were conducted to examine differences in access to contraceptive services through telemedicine by food and housing insecurity, controlling for age, race/ethnicity, health insurance, and other key sociodemographic characteristics. Results: Only 9% of participants received their birth control method through a phone or video visit. One quarter (24%) reported it would be difficult to have a telemedicine visit for birth control. Perceived barriers to telemedicine included lacking privacy at home (42%), not knowing how to do a telemedicine visit (25%), lacking a device or Internet connection (23%), clinics not offering telemedicine (16%), and insurance not covering telemedicine (13%). Half (51%) stated they needed to get their method in person, while 36% would not feel comfortable using telemedicine, and 78% preferred in-person visits. Participants experiencing food insecurity (adjustedOR [aOR], 2.14;95% confidence interval [CI], 1.59–2.88) and housing insecurity (aOR, 1.66;95% CI, 1.16–2.38) were significantly more likely to report that they would have difficulty using telemedicine for birth control. Conclusions: Efforts are needed to remove barriers to telemedicine, particularly for young people facing basic needs insecurity, and to ensure that safe, high-quality in-person contraceptive services also remain accessible.