How do service users choose to obtain routine contraception when using an online contraceptive and sexually transmitted infection (STI) testing service – collection in pharmacy or receipt by postal delivery

22nd June 2023 by Claire Taylor

Sara Day2, Sophie Jones2, Emma Ostridge3, Efejiro Ashano1, Vanessa Apea1,
1Preventx, 2Chelsea and Westminster Hospitals NHS Foundation Trust, 3Lloyds Pharmacy Online Doctor

Background

Online contraception services provide a means of broadening contraception access and served as a key component of sexual health care delivery in the COVID response. An STI screening and contraception e-service, collaboratively funded by 30/33 London local authorities, assesses medical suitability of service users and provides up to 12 months of contraceptive pill/patch/ring, dispatched to home by post or to a community pharmacy for user collection. Examining the uptake of services is pivotal to delivering services which do not exacerbate health inequities. We provide a quantitative description of users of this e-contraception service spanning sixteen London boroughs in 2022 and their chosen mode of routine contraception dispensing.

Method

We conducted a retrospective analysis of individual users of the e-contraception service requesting routine contraception between January 2022 and December 2022, stratifying by chosen mode of dispensing, age, ethnicity and indices of multiple deprivation (IMD).

Results

25540 routine contraception orders were fulfilled in 2022, with 51% of service users being aged 25–34. 35% of all users opted for pharmacy dispensing of contraception rather than postal (9017/25540). All ethnicities were more likely to opt of postal dispatch except for those of Bangladeshi background. Of those choosing pharmacy dispensing those of a Caribbean background formed the largest group amongst those from racially minoritised backgrounds (n=1420). When compared to the proportion ordering routine contraception online, the proportion of Africans collecting at pharmacies are 1.5% higher (9.9% vs 11.4%). In addition, the upper IMD collected contraception in pharmacies at a slightly higher proportion than their respective populations who order online.

Discussion

Over one third of online contraception service users choose face-to-face pharmacy dispensing rather than postal dispatch. Those of Bangladeshi background are more likely to opt for pharmacy dispensing. A deeper understanding of this preference through mixed method research is crucial in shaping equitable services for all.