Objective
To describe perceived race-based discrimination in VA healthcare settings and assess its associations with contraceptive use among a sample of women Veterans.
Methodology
This study used data from a national telephone survey of women Veterans aged 18–44 receiving healthcare in VA who were at risk of unintended pregnancy. Participants were asked about their perceptions of race-based discrimination while seeking VA healthcare and about their contraceptive use at last heterosexual intercourse. Logistic and multinomial regression analyses were used to examine associations between perceived race-based discrimination with use of prescription contraception.
Results
In our sample of 1,341 women Veterans, 7.9% report perceived race-based discrimination when receiving VA care, with blacks and Hispanics reporting higher levels of perceived discrimination than white women (11.3% and 11.2% vs. 4.4%; p<0.001). In logistic and multinomial regression analyses adjusting for race/ethnicity, age, income, marital status, parity, and insurance, women who perceived race-based discrimination were less likely to use any prescription birth control than women who did not (OR:0.65; 95% CI:0.42–1.00), with the largest difference seen in rates of IUD or implant use (OR:0.40; 95%: CI:0.20–0.79).
Conclusions
In this national sample of women Veterans, over 10% of racial/ethnic minority women perceived race-based discrimination when receiving care in VA settings, and perceived racial/ethnic discrimination was associated with lower likelihood of prescription contraception use, especially IUDs and implants. VA efforts to enhance respectful interactions may not only improve patient healthcare experiences, but also represent an opportunity to improve reproductive health outcomes for women Veterans.