How TikTok is being used to talk about abortion post-Roe: A content analysis of the most liked abortion TikToks.

OBJECTIVES: Access to information about abortion is essential for ensuring reproductive autonomy, particularly post-Roe. TikTok, a popular video-sharing application, may be a source of information about abortion, yet little is known about the tone and content of such videos. To fill this gap, we analyze the most liked abortion videos on TikTok three months following the U.S. Supreme Court decision Dobbs v. Jackson Women's Health Organization. STUDY DESIGN: We downloaded the top 200 most liked, publicly available TikTok videos when searching "abortion" on September 26, 2022 and recorded and summarized key video characteristics. We then qualitatively analyzed for content, tone, and common themes. RESULTS: The top 200 most liked TikTok videos collectively had approximately 164 million likes, nearly 10 million shares, and 4 million comments. Most videos expressed support for abortion and presented information that was political or personal in nature. Only two videos contained health information about obtaining or completing an abortion, and only five videos featured or were created by a medical provider. CONCLUSIONS: Findings reveal the far reach of TikTok, which underscores the importance of analyzing online sources of information about abortion. However, our mixed-methods analysis indicates that the most liked TikToks are a source of abortion news, political opinion, personal stories, and debate rather than a source of health information for abortion seekers. IMPLICATIONS: Our analysis finds that the top 200 most liked TikTok videos three months post-Dobbs are primarily political in nature. Relatively few videos provided practical information about accessing abortion care, presenting an opportunity for healthcare providers, public health advocates, and activists to improve access and awareness of new pathways to care. The most popular TikTok videos appear to disseminate news and political information rather than health information about abortion.

A Content Analysis of Reddit Users' Posts about Challenges to Contraceptive care-seeking during COVID-19-related Restrictions in the United States.

The COVID-19 pandemic in the United States caused disruptions in care seeking and delivery during the spring of 2020, including for contraceptive care. We examined how some individuals experienced and responded to barriers to accessing contraceptive care by conducting a content analysis of relevant Reddit posts. We collected 2666 posts by scraping relevant subreddits from February 1, 2020, to April 15, 2020, and filtering by selected keywords. Among the 101 posts on contraception and the COVID-19 pandemic, we explored three main themes: barriers to accessing general healthcare during the early pandemic, problems and concerns specific to contraceptive use, and attempts to navigate the obstacles to contraceptive care or use-related concerns. The Reddit posts demonstrated the disruptive force the early pandemic had on contraceptive care and provided a unique window into the concerns posters expressed on Reddit during this time. Many posters asked questions related to accessing contraception and side effects and sought reassurance from these online forums. Our results suggest that there were barriers to accessing reliable, high-quality, and evidence-based information about contraception during this disruption in care. The findings also underscore that conversational and interactive means of seeking out information are important modes for learning about and discussing contraception for some and may be especially helpful during clinic closures and other restrictions on access.

Patterns in Receipt and Source of STI Testing Among Young People in the United States, 2013-2019.

PURPOSE: Rates of sexually transmitted infections (STIs) among adolescents and young adults (15-24) continue to increase. Limited national information exists about the frequency and source of STI testing among this population. METHODS: We performed a cross-sectional analysis of National Survey of Family Growth data from 2013-2019 to describe patterns in STI testing and assess associations with individual characteristics. RESULTS: We found that non-Hispanic Black women, non-Hispanic Black and Hispanic men, and individuals with public insurance are more likely to receive an STI test. The two sexes have different sources of care for STI testing and publicly supported providers provide the bulk of services to marginalized populations. DISCUSSION: STI testing frequencies of this age group fall below what national guidelines suggest. Multiple socioecological factors may affect the likelihood that a young person receives an STI test. All providers should be supported and encouraged to provide confidential and unbiased STI care.

Financial Instability and Delays in Access to Sexual and Reproductive Health Care Due to COVID-19.

Objective: To identify prevalence of, and patient and clinic characteristics associated with, delays in access to sexual and reproductive health (SRH) care due to the COVID-19 pandemic across three states with varying COVID-19 context and state government response. Methods: We weighted data collected between May 2020 and May 2021 from monthly and biannual follow-up surveys of patients seeking family planning care at a publicly supported health center in Arizona (N = 538), Iowa (N = 341), and Wisconsin (N = 568), who reported on experiences 6-18 months before the survey. We conducted multivariable logistic regression analyses to identify characteristics associated with delays in accessing SRH care due to COVID-19, with specific attention to associations between patients' financial instability and experiencing delays. Results: Between May 2020 and May 2021, over half of respondents in Arizona (57%), 38% in Iowa, and 30% in Wisconsin indicated that they were either unable to access or delayed accessing SRH care or a contraceptive method due to the COVID-19 pandemic. In Arizona and Wisconsin, in multivariable models, respondents who had experienced financial instability due to being out of work, having fallen behind on key life payments, or because of a job reduction or loss due to COVID-19 had increased odds of experiencing COVID-19-related SRH care delays (Arizona adjusted odds ratio [aOR] = 2.6, p = 0.01 and Wisconsin aOR = 6.0, p < 0.001). Conclusions: Access to contraception was curtailed during the COVID-19 pandemic, especially for those who experienced employment and financial instability. Individuals' and clinics' ability to mitigate these effects were likely dependent on state context and response to the pandemic, among other factors.

Comparability of estimates and trends in adolescent sexual and contraceptive behaviors from two national surveys: National Survey of Family Growth and the Youth Risk Behavior Survey.

OBJECTIVE: To compare adolescents' reports of sexual and contraceptive behaviors between the National Survey of Family Growth (NSFG) and the Youth Risk Behavior Survey (YRBS). METHODS: For each survey, we estimated the year- and sex-specific prevalence of sexual and contraceptive behaviors among a comparably defined sample of US respondents ages 15-19 currently attending high school. We used logistic regression to test for changes in prevalence from 2007-2019 and conducted sensitivity analyses to investigate between-survey differences. RESULTS: We found differences in both prevalence and trends between the YRBS and NSFG when limited to a comparably defined sample. Compared to the NSFG, adolescents in the YRBS were more likely to report being sexually experienced, less likely to report use of prescription methods for both sexes, and less likely to report condoms among males. Only the YRBS estimated significant declines in sexual experience for both sexes, and significant increases in prescription methods and declines in condom use among males. Differences between surveys in the prevalence of specific contraceptive methods reflected greater combined use of methods in the NSFG. We identified differences in question-wording and other aspects that may influence these differential patterns. CONCLUSIONS: The NSFG and YRBS produced inconsistent prevalence estimates and trends for sexual and contraceptive behaviors among in-school adolescents. Further efforts to improve these national surveillance systems are critical to inform policy and research efforts that support adolescent sexual and reproductive health and wellbeing.

Incidence of maternal near-miss in Kenya in 2018: findings from a nationally representative cross-sectional study in 54 referral hospitals.

Although the Kenyan government has made efforts to invest in maternal health over the past 15 years, there is no evidence of decline in maternal mortality. To provide necessary evidence to inform maternal health care provision, we conducted a nationally representative study to describe the incidence and causes of maternal near-miss (MNM), and the quality of obstetric care in referral hospitals in Kenya. We collected data from 54 referral hospitals in 27 counties. Individuals admitted with potentially life-threatening conditions (using World Health Organization criteria) in pregnancy, childbirth or puerperium over a three month study period were eligible for inclusion in our study. All cases of severe maternal outcome (SMO, MNM cases and deaths) were prospectively identified, and after consent, included in the study. The national annual incidence of MNM was 7.2 per 1,000 live births and the intra-hospital maternal mortality ratio was 36.2 per 100,000 live births. The major causes of SMOs were postpartum haemorrhage and severe pre-eclampsia/eclampsia. However, only 77% of women with severe preeclampsia/eclampsia received magnesium sulphate and 67% with antepartum haemorrhage who needed blood received it. To reduce the burden of SMOs in Kenya, there is need for timely management of complications and improved access to essential emergency obstetric care interventions.