Purpose

Among U.S. primary care physicians who delivered sexual and reproductive health (SRH) services to adolescents before the COVID-19 pandemic, we examine (1) changes in availability of in-person SRH services; (2) changes in accessibility and utilization of SRH services; and (3) use of strategies to support provision of SRH services during the pandemic.

Methods

Data were from the DocStyles provider survey administered September–October 2020. Descriptive analyses were restricted to family practitioners, internists, and pediatricians whose main work setting was outpatient and whose practice provided family planning or sexually transmitted infection services to ≥ one patient aged 15–19 years per week just before the COVID-19 pandemic (n = 791).

Results

Among physicians whose practices provided intrauterine device/implant placement/removal or clinic-based sexually transmitted infection testing before the COVID-19 pandemic, 51% and 36% indicated disruption of these services during the pandemic, respectively. Some physicians also reported reductions in walk-in hours (38%), evening/weekend hours (31%), and adolescents seeking care (43%) in the past month. At any point during the pandemic, 61% provided contraception initiation/continuation and 44% provided sexually transmitted infection services via telehealth. Among these physicians, about one-quarter reported confidentiality concerns with telehealth in the past month. There were small increases or no changes in other strategies to support contraceptive care.

Conclusions

Findings suggest disruption of certain SRH services and issues with access because of the pandemic among primary care providers who serve adolescents. There are opportunities to enhance implementation of confidential telehealth services and other service delivery strategies that could help promote adolescent SRH in the United States.

中文翻译：

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COVID-19 与性和生殖保健：来自为青少年服务的初级保健提供者的调查结果

目的

在 COVID-19 大流行之前为青少年提供性与生殖健康 (SRH) 服务的美国初级保健医生中，我们检查了 (1) 面对面 SRH 服务可用性的变化；(2) SRH服务可及性和利用的变化；(3) 在大流行期间使用支持提供 SRH 服务的策略。

方法

数据来自于 2020 年 9 月至 10 月进行的 DocStyles 提供者调查。描述性分析仅限于家庭医生、内科医生和儿科医生，其主要工作环境为门诊，其实践为≥一名 15-19 岁患者提供计划生育或性传播感染服务就在 COVID-19 大流行之前的每周数年（n = 791）。

结果

在 COVID-19 大流行之前提供宫内节育器/植入物放置/移除或基于诊所的性传播感染检测的医生中，分别有 51% 和 36% 表示在大流行期间这些服务中断。一些医生还报告说，在过去的一个月里，无需预约的时间 (38%)、晚上/周末的时间 (31%) 和寻求护理的青少年 (43%) 减少了。在大流行期间的任何时候，61% 的人提供避孕开始/继续，44% 的人通过远程医疗提供性传播感染服务。在这些医生中，大约四分之一的人在过去一个月中报告了远程医疗的保密问题。支持避孕护理的其他策略略有增加或没有变化。

结论

调查结果表明，由于为青少年提供服务的初级保健提供者中的大流行，某些 SRH 服务和获取问题的中断。有机会加强保密远程医疗服务和其他服务提供战略的实施，以帮助在美国促进青少年 SRH。