Gluskin Brittany S, O'Connell Maddie, Falk Gretchen, Shrier Lydia A, Guss Carly E
Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.
The Policy & Research Group, New Orleans, LA, USA.
Mhealth. 2023 Apr 3;9:15. doi: 10.21037/mhealth-22-38. eCollection 2023.
Due to decreased access to sexual and reproductive health (SRH) services and an increase in depressive symptoms, the coronavirus disease 2019 (COVID-19) pandemic has exacerbated the risk of unsafe sexual behaviors among already vulnerable young adults assigned female at birth (AFAB). Despite its potential for improving SRH outcomes, little is known about how young adults view virtual SRH counseling. We designed a survey to examine these perspectives and further characterize pandemic-associated changes in mood and healthcare access in young adults AFAB.
Patients of a Midwest family planning organization who were AFAB and aged 21-24 years were recruited via convenience sampling between May and September 2021. Participants answered survey questions about how they perceived that the pandemic had affected their mood and healthcare access. The Patient Health Questionnaire (PHQ)-8 assessed depressive symptoms. Additional questions probed SRH risk behaviors and experience with and opinions on virtual healthcare and research. Non-responses to questions were not included in analyses. Associations among these variables were analyzed using non-parametric bivariate tests (chi-square and Mann-Whitney U).
One hundred twenty people participated in the survey. Participants had a median age of 22 years and self-identified predominantly as female and White. Three-quarters of respondents reported their mood worsened as a result of the pandemic and more than 3 in 10 had depression. Those reporting pandemic-worsened mood had more severe depressive symptoms than those who did not (U=722.500, P=0.005). Most reported sexual intercourse in the past 3 months, nearly all of whom reported at least one SRH risk. Pandemic mood impacts were not associated with SRH risk. One in four participants reported pandemic-associated difficulty accessing healthcare, which was not associated with depression or SRH risk. Most reported comfort with videoconference healthcare, including technology, speaking with a provider, and having enough privacy.
The COVID-19 pandemic has increased depression and SRH risk among young adults AFAB and, at the same, impeded their access to healthcare. The study findings suggest that no matter the degree of depression or presence of SRH risk, videoconferencing may be an acceptable option for advancing research and addressing unmet SRH needs in this population.
由于获得性与生殖健康（SRH）服务的机会减少以及抑郁症状增加，2019年冠状病毒病（COVID-19）大流行加剧了出生时被指定为女性（AFAB）的弱势年轻成年人中不安全性行为的风险。尽管虚拟SRH咨询有改善SRH结果的潜力，但对于年轻成年人如何看待虚拟SRH咨询知之甚少。我们设计了一项调查来研究这些观点，并进一步描述AFAB年轻成年人中与大流行相关的情绪和医疗保健获取方面的变化。
2021年5月至9月期间，通过便利抽样招募了中西部一家计划生育组织中年龄在21 - 24岁且AFAB的患者。参与者回答了关于他们认为大流行如何影响他们的情绪和医疗保健获取的调查问题。患者健康问卷（PHQ）-8评估抑郁症状。其他问题探讨了SRH风险行为以及对虚拟医疗保健和研究的经历与看法。对问题未作回答的情况不纳入分析。使用非参数双变量检验（卡方检验和曼 - 惠特尼U检验）分析这些变量之间的关联。
一百二十人参与了调查。参与者的中位年龄为22岁，自我认定主要为女性和白人。四分之三的受访者表示他们的情绪因大流行而恶化，十分之三以上的人患有抑郁症。报告情绪因大流行而恶化的人比未恶化的人有更严重的抑郁症状（U = 722.500，P = 0.005）。大多数人报告在过去3个月有过性行为，几乎所有人都报告至少有一项SRH风险。大流行对情绪的影响与SRH风险无关。四分之一的参与者报告因大流行难以获得医疗保健，这与抑郁或SRH风险无关。大多数人表示对视频会议医疗保健感到安心，包括对技术、与提供者交谈以及有足够隐私方面。
COVID-19大流行增加了AFAB年轻成年人中的抑郁症和SRH风险，同时阻碍了他们获得医疗保健的机会。研究结果表明，无论抑郁程度或SRH风险状况如何，视频会议可能是推进该人群研究和满足未满足的SRH需求的可接受选择。
