Presentations

Abstract

Introduction: Despite numerous studies documenting the multifaceted effects that COVID-19 has had on U.S. populations, there has been limited research exploring its effect on adolescent sexual and reproductive health (SRH). This study investigates COVID-19's impact on adolescent SRH services and health outcomes through in-depth interviews (IDIs) with adolescents receiving care at outpatient facilities at a single coastal children's health care system.

Methods: We employed a purposive sampling method to recruit key informants for IDIs using four sampling criteria: 1) aged 13-19 years old; 2) had received reproductive health services (i.e. birth control, sexually transmitted infection testing, etc.) in the past year; 3) able to complete an interview in English; 4) provided informed consent. As of July 2024, semi-structured IDIs have been completed by trained medical students with 9 key informants via Zoom. Recruitment continues through the fall of 2024 with an anticipated sample size of 15 key informants. Thematic analysis was performed guided by the grounded theory.

Results: Adolescents reported seeking healthcare services less during COVID due to fear of contracting the virus, as well as noting that it was "a lot harder to get appointments''. Most teens reported using contraceptives (e.g. Depo-Provera and birth control pills). Few teens received counseling about pregnancy or STI by their doctors. The vast majority experienced isolation brought on by COVID which triggered the onset of anxiety, depression, self-harm and suicidal tendency. Many noted: "after Covid hit, I just became a more quiet person", "I just feel like it made me depressed", and "it sent me into a bad depressive episode". Several teens reported parental bereavement, adverse childhood experience, substance use, commercial sex work, use of dialectical behavior therapy, and other treatments since the COVID-19 pandemic.

Conclusion: Findings revealed significant unmet needs for SRH education, counseling and screening services among teens during and post COVID-19 pandemic, as well as syndemics of substance use, ACE, and mental health decline among adolescents who received SRH services.