Does the Perception of Health-Provider Treatment Relate to Accessing Sexual Health Resources for Young Adult Black Females?

Background and Purpose:

To center racial equity in health and social work, the current study examines the role of perceived provider treatment on accessing sexual and reproductive health resources among young Black females. The phrase “perceived treatment” asserts that unconscious biases may be rooted in medical decision-making and centers patient perspectives are the best resource for explaining their experiences with “perceived” discriminatory behaviors. During the Covid-19 quarantine, the lack of sexual and reproductive health (SRH) resources was not prioritized, which further compounded health disparities experienced by young Black females with child-bearing capacity. We examine perceived health treatment and barriers to accessing SRH resources during this time, among a sample of young Black females. This study builds upon literatures that discuss patient-centered care, access to sexual health resources, and disproportionate sexual health disparities experienced specifically among young adult Black females. Study objectives consider the role of historical and structural barriers that disrupt access to adequate health resources necessary for reducing sexual and reproductive health disparities, whether during times of crisis or following inadequate responses, post-crisis. The research questions ask, “How does perceived provider-treatment impact access to SRH resources? And “Which experiences with a provider’s treatment were perceived as a barrier to accessing sexual health resources needed during the coronavirus pandemic?”

Methods:

Using a panel-survey design, a 70-item questionnaire was distributed electronically through Qualtrics to a sample of 712 participants, ages 18 and 29 years, who identify as Black/African American and female, living in the United States. Measures include (1) sexual and reproductive health, such as experiences with health providers, use of birth control methods and birthing experiences; and (2) perceived provider treatment was measured through six questions related to birth control and other reproductive needs. Bivariate correlations and confirmatory factor analysis confirmed that the six indicators were measuring the same factor. A composite score for perceived provider treatment was generated. Logistic regression models were used for determining associations between perceived provider treatment and sexual and reproductive health experiences.

Results:

Poor, perceived provider treatment was associated with poorer SRH experiences, with a decrease in the odds of receiving a prescription for a birth control method (OR: 0.94, CI: 0.91-0.98); receiving a check-up or medical test related to using a birth control method (OR: 0.96, CI: 0.93-0.99); receiving counseling or information about birth control (OR: 0.953, CI: 0.92-0.98); and asking a question about whether the participant wants to become pregnant in the next year (OR: 0.93, CI: 0.90-0.97).

Conclusions and Implications:

According to the CDC, pandemic-related health conditions resulted in more sexually transmitted infections, which may have resulted from similar experiences reported by the study sample. Calls for attention to marginalized groups, whose experiences with sexual health disparities were further compromised due to delays in treatment during Covid-related stay-at-home orders, is important for social work health advocacy post-pandemic. Social work researchers concerned with health outcomes, must advocate for health policies that center healthy equity for those most impacted during the Covid-19 pandemic, and consequently, experience negative health outcomes due to inequitable health treatment.