Rachel P Goossen1, Karen M Summers2, Ginny L Ryan2,3, Michelle A Mengeling3,4,5, Brenda M Booth6,7, James C Torner8,9, Craig H Syrop2, Anne G Sadler3,10. 1. 1 Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah. 2. 2 Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa. 3. 3 Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa. 4. 4 VA Office of Rural Health (ORH), Veterans Rural Health Resource Center, Iowa City, Iowa. 5. 5 Department of Internal Medicine, University of Iowa Carver College of Medicine Iowa City, Iowa City, Iowa. 6. 6 Center for Mental Healthcare Outcomes and Research, Central Arkansas Veterans Healthcare System, Little Rock, Alaska. 7. 7 Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Alaska. 8. 8 Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa. 9. 9 Department of Neurosurgery and Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa. 10. 10 Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Abstract
BACKGROUND: In the general population, infertility is increasingly prevalent in ethnic minority women; these women suffer longer and are less likely to access care. There is a paucity of data regarding the issue of race and infertility in the growing female military veteran population. MATERIALS AND METHODS: This cross-sectional observational study involved computer-assisted telephone interviews of 1,004 Veterans Administration (VA)-enrolled women aged ≤52 years. RESULTS: Racial minority veterans were more likely than white veterans to self-report infertility (24% vs. 18%), equally likely to report infertility evaluation (52% vs. 52%), and less likely to report receiving infertility treatment (31% vs. 63%). Differences in self-reported infertility (odds ratios [OR]: 1.50, 95% confidence interval [CI]: 1.02-2.22) and infertility treatment (OR: 0.32, 95% CI: 0.13-0.81) were retained after controlling for age, income, marital status, education, insurance, history of pelvic inflammatory disease, and lifetime sexual assault. While racial minority veterans were equally as likely as white veterans to be evaluated for infertility, white and racial minority groups reported different reasons for not seeking evaluation. CONCLUSIONS: Consistent with civilian studies, our data suggest that racial minority VA-enrolled female veterans are more likely to self-report infertility and less likely to receive infertility treatment. Future research should investigate whether these findings are consistent nationwide and regardless of VA enrollment, and if minority veterans have unique barriers to care. A better understanding of how the VA might improve awareness of infertility evaluation and treatment options, especially for racial minority veterans, is needed.
BACKGROUND: In the general population, infertility is increasingly prevalent in ethnic minority women; these women suffer longer and are less likely to access care. There is a paucity of data regarding the issue of race and infertility in the growing female military veteran population. MATERIALS AND METHODS: This cross-sectional observational study involved computer-assisted telephone interviews of 1,004 Veterans Administration (VA)-enrolled women aged ≤52 years. RESULTS: Racial minority veterans were more likely than white veterans to self-report infertility (24% vs. 18%), equally likely to report infertility evaluation (52% vs. 52%), and less likely to report receiving infertility treatment (31% vs. 63%). Differences in self-reported infertility (odds ratios [OR]: 1.50, 95% confidence interval [CI]: 1.02-2.22) and infertility treatment (OR: 0.32, 95% CI: 0.13-0.81) were retained after controlling for age, income, marital status, education, insurance, history of pelvic inflammatory disease, and lifetime sexual assault. While racial minority veterans were equally as likely as white veterans to be evaluated for infertility, white and racial minority groups reported different reasons for not seeking evaluation. CONCLUSIONS: Consistent with civilian studies, our data suggest that racial minority VA-enrolled female veterans are more likely to self-report infertility and less likely to receive infertility treatment. Future research should investigate whether these findings are consistent nationwide and regardless of VA enrollment, and if minority veterans have unique barriers to care. A better understanding of how the VA might improve awareness of infertility evaluation and treatment options, especially for racial minority veterans, is needed.
Entities:
Keywords:
access to care; infertility; race and ethnicity; reproductive health; sexual assault; veterans
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