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Getting sexual and reproductive health care online

What providers need to know about telehealth options for birth control, STI, abortion, and more.

by Akilah Wise

published 04/22/20

New telehealth technologies are expanding the way patients can connect with health care providers. And telehealth options can help patients overcome barriers to sexual and reproductive health services by cutting down on the costs associated with an in-person visit, enhancing patient privacy by providing services outside of health centers, and reducing transportation barriers, which can be particularly important for people living in rural areas or contraceptive deserts.

In addition to a wide range of services that are available to patients through telehealth, such as primary care and psychiatry visits, telehealth can help improve access to accurate and trustworthy sexual health information and reproductive health care services, including birth control, sexually transmitted infection (STI) screening and treatment, and abortion. Here is a brief overview of those services:

Birth Control

Telehealth allows patients to get birth control online and delivered to their door or nearest pharmacy through a variety of websites and apps without an in-person visit to a health care provider. Companies, such as Hers, Hey Doctor, Nurx, Pandia Health, Pill Club, PillPack, Planned Parenthood Direct, PRJKT RUBY, Simple Health, and Twentyeight Health, vary slightly in what methods they offer to patients, but most offer short-acting, hormonal birth control, like the pill, patch, the ring, and some even offer emergency contraception and the shot. They ask patients to complete an online health questionnaire to screen for contraindications, and depending on where patients live, a virtual consultation with a provider may be required. Overall, research has shown that telehealth companies are adhering to the CDC’s Medical Eligibility Criteria for Contraceptive Use (US MEC) and are a safe and effective way for people to get birth control.

While the price-points vary for each service, most are free with insurance or offer low- to no-cost options without insurance. Patients interested in learning more about getting their birth control delivered can check out Bedsider for a list of online providers where they live.

Sexually Transmitted Infections (STI)

Testing for STIs in the privacy of a patient’s own space can increase access to screening by protecting patient privacy and reducing indirect costs associated with an in-person visit, such as transportation, childcare, and unpaid time off work. There are several STI testing companies, such as Nurx,, EverlyWell, and MyLab Box, that provide STI testing completely online. For these services, patients order the testing kits online to be delivered to their door, self-collect the samples at anatomic sites of exposure, return the samples by mail, and receive results online within a few days. And evidence suggests that telehealth STI screenings are quite accurate, with specificity and sensitivity for self-collected vaginal swabs and male urine collection comparable to provider-collected samples.

In some cases, patients can even receive STI treatment mailed to them or sent to their local pharmacy, however patients with some positive results, for infections like syphilis or HIV, are referred for in-person follow up and treatment. “Providers could introduce their patients to home testing, telling them to make sure to return for treatment if there should be a positive result,” says Rob Stephenson, Director of the Center for Sexuality and Health Disparities at the University of Michigan. And providers can work with health systems to increase linkages to care for treatment and follow-up for patients who utilize home-based STI testing.

Abortion

Access to medication abortion through telehealth has the potential to reduce barriers to abortion care, especially for people living in geographic areas where TRAP (targeted regulation of abortion providers) laws reduce access to the full spectrum of reproductive health services. Patients accessing medication abortion via telehealth are connected to a health care provider for a videoconference to complete the consultation and screening that otherwise happens in person. Research shows that the success rates and safety of medication abortion via telehealth are similar to in-person care and that medication abortion via telehealth is acceptable to patients. However, restrictions on medication abortions in many states currently require the prescribing provider to be physically present when the medication abortion medications are dispensed limiting widespread access to this service.

General Reproductive Health

Telehealth can also help patients connect with a provider to discuss and treat other related health conditions, including urinary tract infections (UTIs), yeast infections, and bacterial vaginosis (BV). Planned Parenthood Direct offers UTI services in some states and many health insurance plans also offer these services directly to patients. A recent study found UTI services and treatment are effective for “average-risk” patients (high-risk patients were defined as males, people over age 65, or those diagnosed with pyelonephritis).

As telehealth becomes increasingly available and popular, there are more possibilities to help you and your patient overcome barriers to sexual and reproductive health care as well as other services. And engaging with patients through telehealth can be an effective, safe, and convenient way of increasing access to the health care patients need.

Akilah Wise is a public health researcher and freelance journalist living in Atlanta. She earned her doctorate from the University of Michigan School of Public Health where she studied the structural determinants of unintended pregnancy and completed postdoctoral fellowships at Emory University and the Centers for Disease Control and Prevention where she investigated HIV risk. When she's not writing about public health, she's passionately writing fiction.
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