Centering Undocumented Immigrants: A Cross-Sectional Study of Sexual and Reproductive Health of Undocumented Asian and Latinx Immigrants in California

Undocumented immigrants face significant barriers to sexual and reproductive healthcare (SRH); however, there is a dearth of empirical data among this population. This study aims to examine the role of health insurance and SRH use among undocumented immigrants in California. This study uses cross-sectional survey data conducted between July 2020 and May 2022 in California. The final sample includes undocumented female and gender non-conforming adults aged 18–40 years (N = 123). The outcomes of interest include the use of a range of SRH services (i.e., pap smear, pelvic exams, STI testing, contraception, pregnancy tests, or abortion services), ever seeking advice related to SRH, place where SRH services like contraception were obtained, and how respondents paid for services. Bivariate and multivariate analyses were conducted to assess the associations between insurance status and SRH. Overall, 55% of participants used at least one SRH service in the past 12 months. In multivariable results, compared to those with private insurance, those who were uninsured were less likely to seek SRH advice (OR = 0.07; CI: 0.012–0.389) and receive any SRH use in the past 12 months (OR = 0.055; CI: 0.012–0.256). Those with public health insurance were also less likely to receive any SRH in the past 12 months and pay for contraception using insurance compared to those with private insurance. A college degree increased the likelihood of receiving any SRH in the past 12 months. Findings suggest that lack of insurance is strongly associated with lower SRH utilization.