Contraception Use by Title X Clients and Clients of Other Providers, 2015–2019

Introduction

Title X clinics provide access to a wide range of contraceptive options for individuals of all income levels and documentation statuses. As Title X continues to face political uncertainties, it is important to provide up-to-date information about its clients’ use of contraception. This study used recent nationally representative data to compare contraception received by Title X clients with that received by clients of other providers.

Methods

This article draws on 2015–2017 and 2017–2019 waves of the National Survey of Family Growth. The sample was restricted to 15- to 44-year-old women needing contraception. Logistic regressions estimated associations between receiving services at Title X clinics versus at other providers (including private) and use of a range of contraceptive options, as well as number of months’ supply for those using oral contraceptives.

Results

In 2015–2017, Title X was associated with using any contraception (adjusted odds ratio [AOR], 4.11; p = .004). In both waves, Title X clients were more likely to use long-acting reversible contraceptives (AOR, 1.78 in 2015–2017 [p = .023] and AOR, 2.59 in 2017–2019 [p = .003]) and hormonal methods other than oral contraceptives (AOR, 2.31 in 2015–2017 [p = .007] and AOR, 3.04 in 2017–2019 [p = .001]). In both waves, Title X clients using oral contraceptives were also more likely than non-Title X clients to receive more than a 3-month supply (AOR, 3.54 in 2015–2017 [p = .008] and AOR, 2.61 in 2017–2019 [p = .043]). Title X was not associated in either wave with use of barrier or time-based methods, such as periodic abstinence or withdrawal.

Conclusions

Patterns of contraceptive use by Title X clients compared with those of clients of other providers indicate that the Title X program has allowed access to a wide range of contraceptive methods. Ongoing research is necessary to see whether these patterns change over time.