Very Low Percentages of Veterans Have Received Contraception Information from Providers

Greater Healthcare Engagement Might Close Knowledge Gaps

BOSTON — In U.S. veterans of reproductive age, having greater healthcare engagement and more reliance on providers as trusted sources of contraceptive information could improve their knowledge, according to a recent study.

The study published in Contraception examined the associations of contraceptive knowledge among U.S. veterans of reproductive age, focusing on differences by sex, education, healthcare use and primary source of contraceptive information. It aimed to identify factors associated with contraceptive knowledge in both male and female veterans.¹

The study authors are affiliated with RAND, a nonprofit, nonpartisan research organization that provides leaders with information to make evidence-based decisions. The investigators were from RAND offices in Boston; Arlington, VA, and Pittsburgh.

Knowledge about contraceptives is critical to informed decision-making on contraception and contraceptive care. Contraceptive care is available within the VA, but veterans may face barriers to contraceptive counseling, including limited provider time, low awareness of patient services, poor interactions with providers and feeling ostracized. Studies have found that only 27% of female veterans and 6% of male veterans report receiving contraceptive counseling at any healthcare system. Few indicated these discussions took place in the VA setting (18% at a VA hospital and 10% at VA healthcare clinics), the researchers pointed out.

“While barriers to contraceptive knowledge and use have been well documented in female civilian populations, less was known about how both male and female veterans have access to contraceptive care,” Elaine Li, a research associate at RAND, told U.S. Medicine. “Our funder, Arnold Ventures, wanted to better understand veterans’ experiences with contraception and contraceptive care and the impact on choice and access within and outside the VA healthcare system. This paper explored differences in knowledge levels to better understand factors that can improve access and choice to contraceptive care for veterans.”

Using a 2025 nationally representative survey of U.S. veterans of reproductive age (18 to 49), the researchers analyzed data from 542 veterans (both male and female). The survey assessed contraceptive knowledge, access and choice. Age was divided into two categories: those between 18-34 and those 35-49 years old. Marital status was separated into two categories: those who had never been married and those who were currently married, cohabitating with a partner or had once been married (e.g., divorced or annulled, separated, widowed). Race and ethnicity were divided into five categories: white (non-Hispanic), Black (non-Hispanic), Hispanic, two or more races (non-Hispanic) and other (non-Hispanic). The investigators also included the veterans’ education and income levels.

Contraceptive knowledge was considered the primary outcome, and the researchers measured that with 19 questions adapted from the Contraceptive Knowledge Assessment and the National Campaign to Prevent Teen and Unplanned Pregnancy’s “Survey Questions Used to Determine Knowledge of Contraception.” The questions addressed birth control pills, IUDs, vaginal rings, withdrawal, condoms and general birth control knowledge. Healthcare use was measured with one question adapted from the National Survey of Veterans Questionnaire Instruments (2010). A scale developed by other researchers measured source of contraceptive information, and another instrument measured Contraceptive Concerns and Beliefs.

The study found that contraceptive knowledge among veterans overall is low, but higher for those who talked to their providers about it. Providers should initiate contraceptive discussions with men and women, Li suggested.

“While we did not find notable differences in contraceptive care experiences inside and outside of the VA, we identified a large knowledge gap around contraception,” she added.

The veteran respondents were mostly male (81%), white and non-Hispanic (61%), with a median age of 39 years old. Most (77%) completed some college or completed their bachelor’s or an advanced degree. Over half of the respondents (57%) made an annual household income of more than $100,000, and most (85%) of the veterans were married, living together with a partner or were once married, the study reported.

The investigators discovered that less than half of reproductive-age veterans correctly answered contraceptive knowledge questions. Also, only 1 in 10 reported discussing birth control with a provider in the past year. Male veterans demonstrated low awareness of available methods and very limited contraceptive discussions with providers. In fact, male veterans scored significantly lower on contraceptive knowledge than female veterans, the authors explained.

In addition, the researchers determined that higher educational attainment was associated with greater knowledge. Also, any healthcare use in the past 12 months was associated with higher contraceptive knowledge, but this effect was only significant among males. Lastly, females who relied on the internet, social media, books/magazines and personal contacts as their main source of contraceptive knowledge had lower knowledge scores than those who relied on healthcare providers.

“Our results indicate that both male and female veterans trust and rely on their healthcare providers for contraceptive knowledge,” Li said. “At the same time, overall contraceptive knowledge remains low in this population. Thus, clinicians, especially those working in VA settings, should initiate contraceptive counseling discussions with their male and female patients. During these discussions, clinicians should first ask patients if they would like to discuss contraceptive and family planning, and what information they might want to know more about (e.g., method options, how certain methods work, potential side effects and benefits).”

She pointed out that physicians are an important and trusted source of accurate information for veterans and that they should initiate family planning and contraceptive discussions with both men and women to ensure that patients have accurate information and are able to make decisions together.

The study’s findings highlighted the need to build and strengthen contraceptive counseling, particularly for men. Implementing routine conversations about contraception that are led by providers could help close gender gaps in knowledge, normalize contraceptive discussions for all veterans and ensure that veterans have accurate information to make informed decisions about reproductive health, study authors recommended.

The results suggested there are potential gaps in contraceptive knowledge and counseling, but they don’t include information on what factors may shape veterans’ knowledge of contraceptive options, the authors explained.

The authors noted that, while this work was supported by Arnold Ventures, the philanthropic organization wasn’t involved in the study design, collection, analysis and interpretation of data, writing of the report or decision to submit the article for publication.

 

1. Li E, Rollison J, Robbins M, Shinnick D, Miner SA. Contraceptive Knowledge and Related Factors Among Male and Female U.S. Veterans of Reproductive Age. Contraception. 2026 May 22:111511. doi: 10.1016/j.contraception.2026.111511. Epub ahead of print. PMID: 42176835.