Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, health care professionals have made swift accommodations to provide consistent and safe care, including emphasizing remote access to allow physical distancing. Depot medroxyprogesterone acetate intramuscular injection (DMPA-IM) prescription is typically administered by a health care professional, whereas DMPA-subcutaneous has the potential to be safely self-injected by patients, avoiding contact with a health care professional. However, DMPA-subcutaneous is rarely prescribed despite its U.S. Food and Drug Administration approval in 2004 and widespread coverage by both state Medicaid providers and many private insurers. Depot medroxyprogesterone acetate users are disproportionately non-White, and thus the restriction in DMPA-subcutaneous prescribing may both stem from and contribute to systemic racial health disparities. We review evidence on acceptability, safety, and continuation rates of DMPA-subcutaneous, consider sources of implicit bias that may impede prescription of this contraceptive method, and provide recommendations for implementing DMPA-subcutaneous prescribing.

中文翻译：

---

皮下长效醋酸甲羟孕酮在公平避孕护理中的作用：2019 年冠状病毒病 (COVID-19) 大流行的教训。


自 2019 年冠状病毒病 (COVID-19) 大流行开始以来，医疗保健专业人员迅速做出调整，以提供一致和安全的护理，包括强调远程访问以保持身体距离。长效醋酸甲羟孕酮肌内注射 (DMPA-IM) 处方通常由医疗保健专业人员管理，而 DMPA 皮下注射有可能由患者安全地自行注射，避免与医疗保健专业人员接触。然而，尽管美国食品和药物管理局于 2004 年批准了 DMPA 皮下注射，并且得到了州医疗补助提供商和许多私人保险公司的广泛覆盖，但皮下注射 DMPA 的情况却很少见。长效醋酸甲羟孕酮使用者中非白人比例过高，因此对 DMPA 皮下注射处方的限制可能源于并导致系统性种族健康差异。我们审查有关 DMPA 皮下注射的可接受性、安全性和持续率的证据，考虑可能妨碍这种避孕方法处方的隐性偏见来源，并提供实施 DMPA 皮下注射处方的建议。