Barriers to access to over-the-counter oral contraceptives by neighborhood social vulnerability in Boston, Massachusetts.

Oral contraceptives are widely used in the US, but prescription requirements are an access barrier, particularly for adolescents and young adults. Over-the-counter availability of norgestrel 0.075 mg (OPill) was anticipated to improve contraceptive access. This cross-sectional study assessed OPill availability in 17 Boston zip codes, stratified by Social Vulnerability Index (SVI). Among 33 pharmacies, 75.8% presented at least one barrier to access. OPill was available in all stores in low-SVI neighborhoods but not stocked in 13.6% of pharmacies in high-SVI neighborhoods, compounding low access to resources including healthcare. These findings underscore the gap between regulatory approval and equitable real-world contraceptive access.