Intimate partner violence and delays in obtaining contraception among young people in California and Texas

Abstract

Objectives: Experiencing intimate partner violence (IPV) can negatively impact young people's reproductive autonomy, including making it more challenging to get contraception. This study examined the association between IPV and delays in obtaining contraception in a sample of young women from California and Texas.

Study design: The data are from a supplementary study to a cluster randomized controlled trial conducted with young people sexually active within the past year recruited at 29 community colleges during the COVID-19 pandemic (May 2020 to May 2023). We used mixed-effects logistic regression models with random effects for site and individual to assess the association of IPV with delays in obtaining contraception, controlling for key sociodemographic characteristics.

Results: Participants included sexually active individuals aged 18-29 years, assigned female at birth (N = 1698; 7116 observations over time). Over half of the participants (57%) had experienced IPV. Multivariable results showed IPV was associated with delays in obtaining contraception (adjusted odds ratio [aOR] 1.50, 95% CI 1.25-1.79). For each IPV subtype, higher frequency (often compared to rarely) was associated with higher odds of subsequent delays: physical violence (aOR 3.68, 1.77-7.63), threatened (aOR 2.84, 1.71-4.73), and pressured for sex (aOR 2.00, 1.30-3.07).

Conclusions: Experiencing IPV was associated with delays in obtaining contraception. In states with abortion bans and high maternal mortality, including Texas, timely access to contraception is critical. Colleges and other organizations that serve young adults with a high prevalence of IPV should provide easily accessible sexual and reproductive health (SRH) counseling and contraceptive services. Moreover, providers offering SRH care may consider implementing universal trauma-informed IPV screening.

Implications: Young women experiencing IPV across states with widely divergent reproductive policies, California and Texas, were significantly more likely to delay obtaining contraception they thought they needed. Community outreach for trauma-informed IPV screening and accessible SRH services can mitigate these delays and address salient health equity needs across state policy contexts.

Gov id: NCT03519685.

Keywords: Access; Community college; Contraception; Intimate partner violence; Reproductive autonomy; Trauma-informed care; Violence against women; Young people; Young women.