P032 - USE OF ALTERNATIVE ADDRESSES FOR MAILING MEDICATIONS AMONG PATIENTS OBTAINING MEDICATION ABORTION VIA TELEHEALTH

• Published in: Contraception (Stoneham) Vol. 127
• Main Authors: Upadhyay, UD, Koenig, LR, Ko, J, Peters, L, Becker, A
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-11-2023
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2023.110200

Telehealth for abortion has proliferated in the US but is legally permitted in only 25 states. Media reports suggest that some telehealth patients request that medications be mailed to an alternative (non-home) address but the frequency of this practice is unknown.
We used electronic health records and patient survey data collected between April 2021 and January 2022 from the California Home Abortion by Telehealth study, which included patients of three virtual clinics operating in 20 states and Washington, DC. We compared zip codes provided for mailing medications with home zip codes reported in patient surveys, and described frequency of discordance. The surveys also assessed reasons for choosing telehealth and open-ended responses revealed further rationale for this practice.
The 1,600 survey participants lived in 32 states and Washington, DC, including 12 states where telehealth for abortion was not legally permitted. Among the sample, 204 (13%) reported discordant zip codes. Of these, 148 (9%) reported discordant zip codes within the same state and 30 (2%) reported discordant zip codes among differing states where telehealth was legal, suggesting reasons were privacy or convenience. Only 26 (2%) reported discordant zip codes while living in states where telehealth for abortion was not legally permitted. Use of an alternative address was significantly higher among patients under age 25 (20%) and those living in the Northeast (18%) and South (17%).
Providing a non-home address is a common, legal practice among telehealth patients; however, before the Dobbs v Jackson Women’s Health Organization decision, few used it to circumvent state laws.