Perspectives among a Diverse Sample of Women on the Possibility of Obtaining Oral Contraceptives Over the Counter: A Qualitative Study

Background There is increasing support among stakeholders in the United States to make oral contraceptives (OCs) available over the counter (OTC). Previous research on the topic has focused on representative samples of U.S. women, Latina women, low-income women, and abortion clients. However, little is known about the perspectives of African American women, Asian American women, and young women. Methods We conducted 14 focus group discussions with 138 women. Twenty-three percent of participants were ages 18 or younger, 61% were African American, and 26% were Asian American/Pacific Islander. Community organizations recruited participants through convenience sampling and hosted the discussions. Focus groups were transcribed and coded thematically. Findings Women reported potential benefits of OTC access, including convenience and privacy. Many believed OTC availability of OCs would help to reduce unintended pregnancy and help to destigmatize birth control. Participants also expressed concerns about OTC access, such as worry that first-time users and young adolescents would not have enough information to use the pill safely and effectively, as well as concerns about whether women would still obtain preventive screenings. Women were also worried that the cost of OTC OCs would be higher if insurance no longer covered them. Conclusions Overall, women were interested in the option of obtaining the pill OTC. Future research and advocacy efforts should explore women's concerns, including whether adolescents can effectively use OTC pills and ensuring insurance coverage for OTC contraception.

背景 美国的利益相关者越来越支持使口服避孕药（OCs）可在非处方药柜台（OTC）购买。此前关于该主题的研究集中于美国女性、拉丁裔女性、低收入女性和堕胎客户的代表性样本。然而，对于非裔美国女性、亚裔美国女性和年轻女性的观点知之甚少。 方法 我们与138名女性进行了14次焦点小组讨论。23%的参与者年龄为18岁或更小，61%为非裔美国人，26%为亚裔美国人/太平洋岛民。社区组织通过便利抽样招募参与者并主持讨论。焦点小组的讨论内容被转录并进行主题编码。 发现 女性报告了非处方药获取途径的潜在益处，包括便利性和隐私性。许多人认为口服避孕药的非处方药可获取性将有助于减少意外怀孕，并有助于消除对节育的污名化。参与者也表达了对非处方药获取途径的担忧，例如担心首次使用者和青少年没有足够的信息来安全有效地使用避孕药，以及担心女性是否仍会进行预防性筛查。女性还担心如果保险不再覆盖，非处方药口服避孕药的成本会更高。 结论 总体而言，女性对非处方药获取避孕药这一选择感兴趣。未来的研究和宣传工作应探讨女性的担忧，包括青少年是否能够有效使用非处方药避孕药以及确保非处方药避孕的保险覆盖范围。