Online platforms for prescription and supply of hormonal contraception in Australia: a mapping review
Tahlee B. Stevenson
A , Alice Rumbold B C D , Emily Callander E , Pip Buckingham F , Anisa Assifi F , Danielle Mazza F and Luke E. Grzeskowiak B G *
A Faculty of Health and Medical Sciences, School of Public Health, University of Adelaide, Adelaide, SA, Australia.
B SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
C Adelaide Medical School and the Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.
D Women’s and Babies Division, Women’s and Children’s Hospital, North Adelaide, SA, Australia.
E School of Public Health and Preventative Medicine, Monash University, Clayton, Vic., Australia.
F SPHERE CRE, Department of General Practice, Monash University School of Public Health and Preventive Medicine, Melbourne, Vic., Australia.
G Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Sexual Health 20(4) 273-281 https://doi.org/10.1071/SH22138
Submitted: 2 September 2022 Accepted: 13 March 2023 Published: 4 April 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Online platforms have emerged as a convenient way for individuals to access contraception. However, the extent to which such services exist in Australia and how they operate is currently unknown. We aimed to identify Australian online contraception platforms and evaluate the services they provide to determine the degree to which they may facilitate equitable access to contraception. We conducted an internet search to identify online contraception platforms operating in Australia. Data were extracted from each of the platforms relating to operating policies, services provided and associated payment processes, as well as prescribing and screening processes for assessing user suitability. As of July 2022, eight online contraception platforms operating within Australia were identified. All platforms offered oral contraception, with two also offering the vaginal ring, and one emergency oral contraception. None of the platforms provided access to long-acting reversible contraception. Significant variability existed in product and membership costs across platforms, with only one platform providing access to subsidised medicines. Five platforms restricted services to those already using oral contraception. Overall, online questionnaires were deemed to be adequately screening for important contraindications to using oral contraception. While online contraception platforms may be a valuable option for some individuals who face access barriers and are willing to pay out-of-pocket for to have their contraception sent straight to their home, they do not necessarily ensure that individuals can access their contraceptive method of choice or address recognised financial and structural barriers to contraceptive care.
Keywords: contraception access, emergency contraceptive pill, hormonal contraception, online prescriber, online provider, oral contraception, reproductive autonomy, telemedicine.
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