Search

BackgroundThe COVID-19 pandemic led to widespread college campus closures in the months of March to June 2020, endangering students’ access to on-campus health resources, including reproductive health services. ObjectiveTo assess contraceptive access and use among undergraduate and graduate students in North Carolina during the COVID-19 pandemic. MethodsWe conducted a cross-sectional web-based survey of undergraduate and graduate students enrolled at degree-granting institutions in North Carolina. Participants were recruited using targeted Instagram advertisements. The survey queried several aspects of participants’ sexual behavior, including sex drive, level of sexual experience, number of sexual partners, digital sexual experience, dating patterns, and types of contraception used. Participants were asked to compare many of these behaviors before and after the pandemic. The survey also assessed several sociodemographic factors that we hypothesized would be associated with contraceptive use based on prior data, including educational background, sexual orientation and gender minority status (ie, lesbian, gay, bisexual, transgender, queer), health insurance status, race, ethnicity, degree of sensation seeking, religiosity, and desire to become pregnant. ResultsOver 10 days, 2035 Instagram users began our survey, of whom 1002 met eligibility criteria. Of these 1002 eligible participants, 934 completed the survey, for a 93% completion rate. Our respondents were mostly female (665/934, 71%), cisgender (877/934, 94%), heterosexual (592/934, 64%), white (695/934 75%), not Hispanic (835/934, 89%), and enrolled at a 4-year college (618/934, 66%). Over 95% (895/934) of respondents reported that they maintained access to their preferred contraception during the COVID-19 pandemic. In a multivariable analysis, participants who were enrolled in a 4-year college or graduate program were less likely to lose contraceptive access when compared to participants enrolled in a 2-year college (risk ratio [RR] 0.34, 95% CI 0.16-0.71); in addition, when compared to cisgender participants, nonbinary and transgender participants were more likely to lose contraceptive access (RR 2.43, 95% CI 1.01-5.87). Respondents reported that they were more interested in using telehealth to access contraception during the pandemic. The contraceptive methods most commonly used by our participants were, in order, condoms (331/934, 35.4%), oral contraception (303/934, 32.4%), and long-acting reversible contraception (LARC; 221/934, 23.7%). The rate of LARC use among our participants was higher than the national average for this age group (14%). Emergency contraception was uncommonly used (25/934, 2.7%). ConclusionsUndergraduate and graduate students in North Carolina overwhelmingly reported that they maintained access to their preferred contraceptive methods during the COVID-19 pandemic and through changing patterns of health care access, including telehealth. Gender nonbinary and transgender students and 2-year college students may have been at greater risk of losing access to contraception during the first year of the COVID-19 pandemic.

Objectives: To identify rates of telemedicine provision during the COVID-19 pandemic and predictive institutional factors among 4-year and graduate colleges and universities. Participants: The study (n = 364) included the websites (.edu) of accredited public nonprofit, private nonprofit, and private for-profit institutions of higher education in the United States that award bachelors, masters, or doctoral degrees. Methods: Using digital content analysis, human coders analyzed institution websites for informational text indicating student telemedicine services. Results: Findings indicate that a minority of 4-year and above institutions offer telemedicine access. Institution type, institution size, and the presence of campus student health services were predictive. Endowment size and Minority Serving Institution status were not predictive. Conclusion: This study illustrates the ongoing need for increased access to remote health services across higher education, especially among smaller private and public nonprofit colleges and universities and all private for-profit institutions.