Reproductive Health Preventive Screening among Clinic and Over-the-Counter Oral Contraceptive Users in El Paso, Texas

Kristine Hopkins, University of Texas at Austin
Daniel Grossman, Ibis Reproductive Health
Jon Amastae, University of Texas at El Paso

Growing interest in the possibility of moving oral contraceptives to over the counter (OTC) have raised concerns about whether women would continue to get needed preventive health screening, such as Pap smears. We took advantage of a natural experiment on the US-Mexico border where women can obtain pills from US clinics or OTC at Mexican pharmacies. We assessed the prevalence of reproductive health screening (cervical/breast cancer and STI screening) using Poisson regression models. The prevalence of screening was high for both groups (>87% for 4 of 5 measures), although clinic users had a higher prevalence, even after multivariable adjustment. Among OTC users, reasons given for no Pap screening included inconvenience, cost, or not knowing where to get screening. These results indicate that women would continue to obtain preventive screening if the pill were available OTC, and highlight the importance of improving access to preventive screening services.