JMIR Publications

ABSTRACT

Background:

The coronavirus disease 2019 (COVID-19) pandemic led to widespread college campus closures in the spring of 2019, endangering students’ access to on-campus health resources, including reproductive health services.

Objective:

To assess contraceptive access and use among college and graduate students in North Carolina during the COVID-19 pandemic.

Methods:

We conducted a cross-sectional web-based survey of college and graduate students enrolled in degree-granting institutions in North Carolina. Participants were recruited using targeted Instagram advertisements.

Results:

Over 10 days, 2,035 Instagram users began our survey, of whom 1,002 met eligibility criteria. 934 of 1,002 eligible participants completed the survey for a 93% completion rate. Our respondents were mostly female (71%), cisgender (94%), heterosexual (64%), white (75%), not Hispanic (89%), and enrolled at a four-year college (66%). Over 95% of respondents reported that they maintained access to their preferred contraception during the COVID-19 pandemic. In multivariable analysis, enrollment in a four-year college or graduate program was protective against decreased contraceptive access (risk ratio [RR] 0.34, 95% CI 0.16-0.71) whereas, compared to cisgender participants, non-binary and transgender participants had an increased risk of decreased contraceptive access (RR 2.43, 95% CI 1.01-5.87). Respondents reported that they were more likely to use telehealth to access contraception during the pandemic.

Conclusions:

College and graduate students in North Carolina overwhelmingly reported that they maintained access to their preferred contraceptive methods during the COVID-19 pandemic and changing patterns of healthcare access, including through telehealth. Gender nonbinary and transgender students and two-year college students may be at greater risk of decreased contraceptive access.