U.S. Women's Use of Sexual and Reproductive Health Services: Trends, Sources of Care and Factors Associated with Use, 1995–2010

Author(s)

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Key Points

Key Points

• Seven in 10 U.S. women of reproductive age, some 43–45 million women, make at least one medical visit to obtain sexual and reproductive health (SRH) services each year. Uninsured women are significantly less likely than either privately or Medicaid-insured women to receive SRH services. Approximately 25 million women receive contraceptive services annually.

• The number of women having either a Pap test or pelvic exam each year fell from 41 million in 2002 to 39 million in 2006–2010, consistent with recent changes in cervical cancer screening recommendations. n The number of women receiving STD testing, treatment or counseling each year doubled from 4.6 million in 1995 to 9.8 million in 2006–2010, reflecting both an increase in routine chlamydia screening now recommended for all sexually active women younger than age 25, as well as an increase in the reported incidence of chlamydia.

• The number of women receiving any SRH service who went to a publicly funded clinic for that care rose from 7.3 million (17% of those receiving care) in 1995 to 10.2 million (23%) in 2006–2010, mirroring concurrent increases in the number of women in poverty and in need of publicly funded contraceptive services. Compared with women receiving services from private doctors, women going to publicly funded clinics received a wider range of SRH services and were more likely to have conversations about contraception during annual gynecologic visits.

• Title X–funded clinics continue to play an important role in providing SRH care to poor and low-income women—14% of all women who receive any contraceptive service obtain that care from these clinics, as do 25% of poor women and 36% of uninsured women receiving care. In fact, six in 10 women (61%) visiting Title X–funded clinics for contraceptive and related services report that the clinic is their usual source for medical care.

• Between 1995 and 2006–2010, there was a significant rise in the use of private insurance to pay for contraceptive visits—from 48% to 63%. Going forward, the Affordable Care Act is likely to accelerate this trend.