ASSOCIATION BETWEEN EXPERIENCES OF DISCRIMINATION AND CONCERNS ABOUT ACCESSING CONTRACEPTIVE CARE AMONG COMMUNITY COLLEGE STUDENTS IN TEXAS AND CALIFORNIA

Objectives

We aimed to identify whether experiences of discrimination are associated with students’ concerns about accessing contraception.

Methods

We analyzed baseline data (n=2,086) from an ongoing cluster randomized trial in Texas and California with sexually active community college students aged 18-25, assigned female at birth (gender- inclusive). Experiences of Discrimination (EOD) were measured using a validated and reliable scale (α = 0.8). We examined the association between EOD and concerns about being judged or disrespected by a medical provider, and whether the student felt comfortable discussing contraception with a provider. We used mixed effects logistic regression for clustered data, controlling for key sociodemographic factors.

Results

Overall, 21% of participants reported concerns about being judged or disrespected, and 17% reported feeling uncomfortable discussing contraception. EOD positively correlated with concerns about judgment or disrespect (adjusted OR (aOR)=1.13, CI 95% 1.09-1.16) and discomfort discussing contraception (aOR=1.04, CI 95% 1.01-1.08). Asian/Pacific Islanders had higher odds of worrying about judgment/disrespect (aOR=1.95, CI 95% 1.28-2.99) and discomfort discussing contraception (aOR=1.99, CI 95% 1.25-3.16) compared to White students. Latinx students also had higher odds of discomfort discussing contraception (aOR=1.52, CI 95% 1.04-2.23) as did first-generation college students (aOR=1.37, CI 95% 1.04-1.80). Finally, not speaking English at home was associated with concerns about judgment or disrespect (aOR=1.31, CI 95% 1.01-1.70).

Conclusions

Experiences of discrimination are associated with concerns about being judged or disrespected, as well as discomfort discussing contraception with providers. Healthcare providers and institutions should recognize and work to reduce the impact of discrimination on patients, particularly among young and marginalized patient communities.