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O19Experiences of racial/ethnic discrimination and contraceptive use: A longitudinal study

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      Objectives

      Racism is associated with undesired pregnancy, but no studies examine how experiencing discrimination might shape pregnancy preferences or contraceptive use.

      Methods

      We recruited n=1,790 non-pregnant individuals, with the capacity for pregnancy, aged 15–34 from 20 health facilities in West Texas, Nevada, Arizona, New Mexico, and Southern California and followed them for a year (2019–2022). At baseline, participants completed the everyday discrimination measure (poor daily treatment based on race/ethnicity, sometimes/often vs. rarely/never). At baseline and at quarterly intervals, they completed the Desire to Avoid Pregnancy (DAP) scale (range: 0–4, higher score=greater desire to avoid pregnancy) and reported contraceptive method use. Using adjusted multivariable mixed-effects models, we examined associations between discrimination, pregnancy preferences, contraceptive method, and method satisfaction over one year.

      Results

      Of the sample (55% Latinx, 22% White, 14% multiracial/other, 8% Black), 25% reported sometimes or often experiencing discrimination. Discrimination was more common among Black (50%), multiracial/other (30%) and Latinx (25%) participants (vs. 11% White; adjusted ORs (aORs), 8.5, 3.5 and 3.1, respectively). Those who reported discrimination had higher preference to avoid pregnancy, on average, adjusting for race/ethnicity and covariables (marginal mean, 2.51 vs. 2.30; adjusted Coefficient=0.20 [0.10, 0.32]). Contrary to hypotheses, among those preferring to avoid pregnancy, discrimination was positively associated with condom (aOR, 1.83 [1.31, 2.57]) and prescription method use (aOR, 1.66 [1.26, 2.20]) vs. no method, but marginally negatively associated with method satisfaction (aOR, 0.74 [0.52, 1.04]).

      Conclusions

      Experiencing discrimination may influence feelings about becoming pregnant and method satisfaction. Women's pregnancy preferences and contraceptive choices are not immune from the impact of racism or xenophobia.
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