by Kate Ebbutt
Clune M (Preventx), Ebbutt K (Preventx), Goward C (Preventx), Perera S (Lloyds Pharmacy Online Doctor)
The COVID-19 pandemic has moved some health services, such as contraception, online. Eleven London local authorities collaboratively commissioned a routine contraception (RC) e-service in September 2020. After completing an online asynchronous consultation, RC can be delivered to the e-service user or collected in pharmacy.
Retrospective analysis of RC consultations completed between 1st January 2021 and 31st December 2021, by Sexual Health London service users (SU). Age, ethnicity and deprivation decile were used to identify demographic trends.
10,525 RC consultations were completed. Most consultations were completed by SU: aged 25-34 year olds (47.9%, n=5042); from the lower Index of Multiple Deprivation (IMD) deciles 2-4 (61.2%, n=6442); from ethnic minority groups (66.7%, n=7021). In 16-17 year olds and 35-44 year olds, the majority of RC consultations were completed by users in the bottom 3 deciles of deprivation (55.5% (n=146) and 55.8% (n=383) respectively). 68% (n=607) of Black African women were from the bottom 3 deciles of deprivation, as were 59.5% (n=606) of Black Caribbean women as compared to 40.6% (n=1432) of White British women. 46.1% (n=412) of Black African women, 51.9% (n=576) of Black Caribbean women, and 45.5% (n=1595) of White British women, were 16-24 years old.
Over two thirds of individuals accessing RC online were from minority ethnic groups and/or from areas of deprivation. Accessing contraception online is acceptable to those living in the lower deciles of deprivation. 64.9% of orders from women who live in the bottom 4 deciles of deprivation, the average decile of deprivation for the eleven boroughs is 5. (Ministry of Housing, Communities and Local Government, 2019) . Online contraception was also acceptable to young women (<16-24yrs) who represented almost 45% of RC orders. Most consultations (47.9%) were completed by service users aged 25-34 year olds. This group account for 21.8% of the London population aged 16 and over (Statista, 2021). An online RC service can reach populations that experience health inequalities including poor sexual health outcomes and high unintended pregnancy rates. Local authorities could consider whether an online RC service would help in their area.