Confirmatory factor analysis of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in community health center patients.

Disability status and experiences of chronic health conditions may influence whether individuals receive wanted and needed reproductive healthcare, including contraceptive care. National studies estimate that nearly 20% of reproductive-age individuals live with a disability involving difficulty with hearing, vision, cognition, mobility, self-care, and independent living (, ). Experiences of disability may constrain reproductive health care access and reproductive health choices (; ), which occur in light of the historical context of forced sterilization and eugenics. In addition, the ongoing impact of structural ableism in medicine and public health often devalues the experiences and needs of disabled people (). To support reproductive autonomy, disabled people and people with chronic health conditions should have access to the full spectrum of contraceptive methods and comprehensive sexual and reproductive health care (; ). Research using nationally representative and state-level data provides evidence that contraceptive use and contraceptive service utilization differ by disability status. Women with disabilities are more likely to be sterilized and less likely to use moderately effective methods or long-acting reversible contraception (e.g., intrauterine devices (IUD) and implants) compared to non-disabled women (; ; ), as well as less likely to receive family planning services (). However, this narrow focus on contraceptive mix does not provide information about contraceptive users’ satisfaction with these methods or the use of non-preferred methods. Despite a growing body of research examining unmet contraceptive preferences (; ; ; ; ), to our knowledge, this issue has not been examined by disability status. Further research is needed to identify current patterns in method satisfaction and motivations for switching or discontinuing methods among disabled individuals. Recent changes in contraceptive service guidelines and an increased emphasis on person-centered and justice-informed sexual and reproductive healthcare may have helped reduce the disparities by disability status in contraceptive care and behaviors observed in earlier studies (; ). In this study, we used a nationally representative household survey to assess potential differences in contraceptive experiences for disabled and non-disabled individuals. We examined differences by disability status in two key outcomes related to contraceptive satisfaction: report of stopping a contraceptive method because of dissatisfaction with the method, and report of a desire to switch to another contraceptive method or try a new method if cost were not a barrier to use. Understanding these experiences can help identify needs and provide the research and clinical care communities with potential mechanisms for interventions to improve contraceptive care for the disabled population.