Adolescents' perceived difficulty in accessing sexual and reproductive health services before, during, and after the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic widely disrupted access to sexual health care but little is known about how these disruptions were perceived by adolescents. We evaluated changes in adolescents' perceived difficulty accessing sexual and reproductive healthcare products and services during and after the COVID-19 pandemic.

METHODS

We performed a cross-sectional analysis within an online longitudinal study of adolescents aged 13-17 years (N = 1721) recruited between 2022 and 2023 (QuaranTeen Health). Participants rated perceived difficulty accessing sexual and reproductive healthcare products and services (i.e. birth control/contraception, human immunodeficiency virus [HIV] and other sexually transmitted infection [STI] testing, condoms, and appointments with healthcare providers [HCP]) for three time points: (1) before the pandemic; (2) during the acute phase of the pandemic; and (3) within the past 2 months using a 5-point Likert scale (strongly disagree to strongly agree).

RESULTS

Pre-pandemic, 30% (475/1594) of participants reported perceived difficulty accessing birth control, 29% for condoms (462/1591), 25% for HIV/STI testing (400/1588), and 17% for HCP appointments (294/1685). Perceived difficulty accessing all services was higher during (vs before) the acute phase of the pandemic: 37% for both birth control (590/1582) and condoms (589/1578); 38% (612/1580) for HIV/STI tests; and 42% for HCP appointments (701/1668). Perceived difficulty accessing birth control and HIV/STI tests persisted (38%, 424/1107 and 37%, 410/1095, respectively). The perceived difficulty of getting condoms or an HCP appointment decreased (30%, 320/1079 and 31%, 347/1121, respectively) but remained higher than pre-pandemic.

CONCLUSIONS

The COVID-19 pandemic increased perceived difficulty in accessing sexual and reproductive health products and services, and these perceived difficulties may persist.