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Sexual orientation disparities in contraceptive use and abortion care

Brittany Charlton, MSc, ScD, Harvard Medical School and Boston Children’s Hospital, 2015

Project abstract

Compared to their heterosexual peers, sexual minority (i.e., lesbian and bisexual) girls and women are particularly vulnerable to having poor reproductive health. Our study team has recently documented that sexual minorities are less likely to receive preventative care like Pap tests and more likely to experience a teen pregnancy. We have shown that these disparities are, in part, due to less contraception use among sexual minorities. However, no research exists on the full range of contraceptive use or abortion care across different sexual orientation groups. In particular, there is concern that sexual minorities are less likely to: use highly effective contraceptive methods to prevent a teen pregnancy, use prescription-based contraceptive methods that bring them into the healthcare system for routine care, and have access to much needed abortion care. In the proposed project, we argue that there may be disparities in contraceptive use (aim 1) and abortion care (aim 2) by sexual orientation. To fulfill these aims, national data will be analyzed from four longitudinal cohorts with nearly 200,000 girls and women in the Nurses’ Health Study 2 and 3 as well as the Growing Up Today Study 1 and 2. The proposed research will not only test for possible sexual orientation disparities in contraceptive use and abortion care but also help to understand a woman’s family planning preferences. This work will inform interventions such as refining provider education about sexual minority care and improve provider-patient communication.


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