Donovan P
Fam Plann Perspect. 1991 Sep-Oct;23(5):198-203.
Family planning clinics throughout the United States are facing a variety of obstacles that threaten their ability to provide necessary contraceptive services to low-income women and teenagers, according to interviews with clinic administrators. In the last few years, the proportion of patients coming to family planning agencies in need of screening or treatment for sexually transmitted diseases (STDs) has increased dramatically. Many providers report that 10-15 percent of their clients are infected with chlamydia, the most prevalent STD. The increasing costs of Pap tests and contraceptives are also major problems: As a result of recent federal legislation, the price of Pap tests has risen substantially, and that of contraceptives is beginning to increase steeply. Finally, Title X funding for family planning services has decreased 66 percent over the last decade if both cuts and inflation are taken into account. As a result of the squeeze between increased costs and decreased public funding, clinics have been forced to charge higher fees, maintain long waiting lists for appointments and curtail community outreach. In addition, growth of the family planning patient population has slowed dramatically, and even declined, in some places.
根据对诊所管理人员的访谈，美国各地的计划生育诊所正面临着各种障碍，这些障碍威胁到它们为低收入妇女和青少年提供必要避孕服务的能力。在过去几年里，前来计划生育机构需要筛查或治疗性传播疾病（STD）的患者比例急剧上升。许多提供者报告说，他们10%至15%的客户感染了衣原体，这是最常见的性传播疾病。巴氏试验和避孕药具成本的不断增加也是主要问题：由于最近的联邦立法，巴氏试验的价格大幅上涨，避孕药具的价格也开始急剧上涨。最后，如果将削减和通货膨胀因素都考虑在内，过去十年里用于计划生育服务的第十类拨款减少了66%。由于成本增加和公共资金减少的双重挤压，诊所被迫收取更高的费用，维持很长的预约等候名单，并减少社区宣传活动。此外，计划生育患者群体的增长大幅放缓，在某些地方甚至出现了下降。
