Racial and Ethnic Disparities in Contraceptive Knowledge Among Women Veterans in the ECUUN Study

Abstract: To assess whether racial/ethnic disparities in contraceptive knowledge observed in the general US population are also seen among women Veterans served by the Veterans Affairs (VA) healthcare system. We analyzed data from a national telephone survey of 2302 women Veterans aged 18–44 who had received care within VA in the prior 12 months. Twenty survey items assessed women's knowledge about various contraceptive methods. Multivariable logistic regression was used to examine racial/ethnic variation in contraceptive knowledge items, adjusting for age, marital status, education, income, parity, and branch of military service.
Contraceptive knowledge was low among all participants, but black and Hispanic women had lower knowledge scores than whites in almost all knowledge domains. Compared to white women, black women were significantly less likely to answer correctly 15 of the 20 knowledge items, with the greatest adjusted difference observed in the item assessing knowledge about the reversibility of tubal sterilization (adjusted percentage point difference (PPD): −23.0; 95% CI: −27.8, −18.3). Compared to white women, Hispanic women were significantly less likely to answer correctly 11 of the 20 knowledge items, with the greatest adjusted difference also in the item assessing tubal sterilization reversibility (PPD: −13.1; 95% CI: −19.5, −6.6). Contraceptive knowledge among women Veterans served by VA is suboptimal, especially among racial/ethnic minority women. Improving women's knowledge about important aspects of available contraceptive methods may help women better select and effectively use contraception. Providers in the VA healthcare system should assess and address contraceptive knowledge gaps as part of high-quality, patient-centered reproductive health care.