2014 Fpar

August 2015

Title X
Family Planning
Annual Report
2014 National Summary

August 2015

Family Planning Annual Report:
2014 National Summary

Prepared for
Office of Population Affairs

Office of the Assistant Secretary for Health
U.S. Department of Health and Human Services
1101 Wootton Parkway, Suite 700
Rockville, MD 20852

Prepared by
RTI International

3040 East Cornwallis Road
P.O. Box 12194
Research Triangle Park, NC 27709

_________________________________
RTI International is a registered trademark and a trade name of Research Triangle Institute.

SUGGESTED CITATION
Fowler, C. I., Gable, J., Wang, J., & Lasater, B. (2015, August). Family Planning Annual
Report: 2014 national summary. Research Triangle Park, NC: RTI International.

ADDITIONAL COPIES
This report can be viewed, downloaded, and printed from the Office of Population Affairs
Website at http://www.hhs.gov/opa/title-x-family-planning/research-and-data/fp-annualreports/#fpar.

ACKNOWLEDGMENTS
This report was prepared by RTI International under OPA contract number
HHSP23320095651WC/HHSP23337041T. RTI staff who prepared the report include
Christina Fowler (Project Director and Senior Health Services Research Analyst), Julia Gable
(Statistician), Jiantong Wang (Statistician), and Beth Lasater (Information Systems Analyst).
The conclusions expressed in this report are those of the authors and do not necessarily
represent the views of HHS or OPA. Sharon Barrell and Margaret Smith (Editors); Roxanne
Snaauw, Cathy Boykin, and Judy Cannada (Document Preparation Specialists); and Cheryl
Velez, Kimberly Cone, Teresa Bass, and Danny Occoquan (Web Conversion Team) provided
publications assistance. Nathan Sikes, Yuying Zhang, Al-Nisa Berry, and Vesselina Bakalov
provided support for web-based data collection.
For their help resolving data validation issues and reviewing the final report, the authors
thank U.S. Department of Health and Human Services (HHS) staff CDR Nancy MautoneSmith (Public Health Advisor, OPA) and HHS Regional Project Officers.
Finally, publication of this report would not have been possible without the contributions of
Title X service grantees and subrecipients that collect, compile, and submit FPAR data to
OPA.

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Family Planning Annual Report: 2014 National Summary

CONTENTS
Executive Summary ............................................................................. 1
1

Introduction ........................................................................................ 1

Title X National Family Planning Program ........................................................................... 1
Family Planning Annual Report ............................................................................................ 1
Report Structure ..................................................................................................................... 3
2

FPAR Methodology .............................................................................. 5

Data Collection ...................................................................................................................... 5
Data Reporting ....................................................................................................................... 5
Data Validation ...................................................................................................................... 5
3

Findings .............................................................................................. 7

Grantee Profile ....................................................................................................................... 7
Family Planning User Demographic Profile .......................................................................... 8
Total Users (Exhibit 3) .................................................................................................... 8
Users by Sex (Exhibits 4 and 5) ...................................................................................... 8
Users by Age (Exhibits 4 and 5) ..................................................................................... 9
Users by Race (Exhibits 6 through 14) ......................................................................... 12
Users by Ethnicity (Exhibits 6 through 14) ................................................................... 12
Family Planning User Social and Economic Profile ............................................................ 21
Users by Income Level (Exhibit 15) ............................................................................. 21
Users by Insurance Coverage Status (Exhibit 16) ......................................................... 21
Limited English Proficient Users (Exhibit 17) .............................................................. 24
Primary Contraceptive Method Use ..................................................................................... 27
Female Users by Primary Contraceptive Method (Exhibits 18 through 21) ................. 27
Trends in Female Primary Contraceptive Method Use ................................................. 29
Male Users by Primary Contraceptive Method (Exhibits 22 through 25) ..................... 35
Cervical and Breast Cancer Screening ................................................................................. 41
Cervical Cancer Screening (Exhibit 26) ........................................................................ 41
Breast Cancer Screening (Exhibit 26) ........................................................................... 41
Sexually Transmitted Disease Testing ................................................................................. 43
Chlamydia Testing (Exhibits 27 and 28)....................................................................... 43
Gonorrhea Testing (Exhibit 29) .................................................................................... 44
Syphilis Testing (Exhibit 29) ........................................................................................ 44
Family Planning Annual Report: 2014 National Summary

iii

Human Immunodeficiency Virus Testing (Exhibit 29) ................................................. 44
Staffing and Family Planning Encounters............................................................................ 49
Clinical Services Provider Staffing (Exhibit 30) ........................................................... 49
Family Planning Encounters (Exhibit 30) ..................................................................... 49
Revenue................................................................................................................................ 53
Title X Services Grant ................................................................................................... 53
Payment for Services: Client Fees ................................................................................ 53
Payment for Services: Third-Party Payers .................................................................... 53
Other Revenue............................................................................................................... 54
Revenue per User .......................................................................................................... 54
Revenue Trends ............................................................................................................. 57
4

References ........................................................................................ 61

Appendixes

A. National Trend Exhibits .............................................................................................. A-1
B. State Exhibits............................................................................................................... B-1
C. Field and Methodological Notes ................................................................................. C-1
Exhibits

1. U.S. Department of Health and Human Services regions ............................................... 2
2. Number of and percentage change in grantees, subrecipients, and service sites,
by year and region: 2013–2014 (Source: FPAR Grantee Profile Cover Sheet) .............. 7
3. Number, distribution, and percentage change in number of all family planning
users, by year and region: 2013–2014 (Source: FPAR Table 1) ..................................... 8
4. Number of all family planning users, by sex, age, and region: 2014
(Source: FPAR Table 1) ................................................................................................ 10
5. Distribution of all family planning users, by sex, age, and region: 2014
(Source: FPAR Table 1) ................................................................................................ 11
6. Number and distribution of all family planning users, by race and ethnicity:
2014 (Source: FPAR Tables 2 and 3) ............................................................................ 13
7. Number and distribution of female family planning users, by race and
ethnicity: 2014 (Source: FPAR Table 2) ....................................................................... 13
8. Number and distribution of male family planning users, by race and ethnicity:
2014 (Source: FPAR Table 3) ....................................................................................... 13
9. Number of all family planning users, by race, ethnicity, and region: 2014
(Source: FPAR Tables 2 and 3) ..................................................................................... 14

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Family Planning Annual Report: 2014 National Summary

10. Distribution of all family planning users, by race, ethnicity, and region: 2014
(Source: FPAR Tables 2 and 3) ..................................................................................... 15
11. Number of female family planning users, by race, ethnicity, and region: 2014
(Source: FPAR Table 2) ................................................................................................ 16
12. Distribution of female family planning users, by race, ethnicity, and region:
2014 (Source: FPAR Table 2) ....................................................................................... 17
13. Number of male family planning users, by race, ethnicity, and region: 2014
(Source: FPAR Table 3) ................................................................................................ 18
14. Distribution of male family planning users, by race, ethnicity, and region:
2014 (Source: FPAR Table 3) ....................................................................................... 19
15. Number and distribution of all family planning users, by income level and
region: 2014 (Source: FPAR Table 4) ........................................................................... 22
16. Number and distribution of all family planning users, by principal health
insurance coverage status and region: 2014 (Source: FPAR Table 5) .......................... 23
17. Number and distribution of all family planning users, by limited English
proficiency (LEP) status and region: 2014 (Source: FPAR Table 6) ............................ 25
18. Number of female family planning users, by primary contraceptive method
and age: 2014 (Source: FPAR Table 7) ......................................................................... 30
19. Distribution of female family planning users, by primary contraceptive method
and age: 2014 (Source: FPAR Table 7) ......................................................................... 31
20. Number of female family planning users, by primary contraceptive method
and region: 2014 (Source: FPAR Table 7) .................................................................... 32
21. Distribution of female family planning users, by primary contraceptive method
and region: 2014 (Source: FPAR Table 7) .................................................................... 33
22. Number of male family planning users, by primary contraceptive method and
age: 2014 (Source: FPAR Table 8) ............................................................................... 36
23. Distribution of male family planning users, by primary contraceptive method
and age: 2014 (Source: FPAR Table 8) ......................................................................... 37
24. Number of male family planning users, by primary contraceptive method and
region: 2014 (Source: FPAR Table 8) ........................................................................... 38
25. Distribution of male family planning users, by primary contraceptive method
and region: 2014 (Source: FPAR Table 8) .................................................................... 39
26. Cervical and breast cancer screening activities, by screening test or exam and
region: 2014 (Source: FPAR Tables 9 and 10).............................................................. 42
27. Number of family planning users tested for chlamydia, by sex, age, and region:
2014 (Source: FPAR Table 11) ..................................................................................... 46
28. Percentage of family planning users in each age group tested for chlamydia, by
sex, age, and region: 2014 (Source: FPAR Table 11) ................................................... 47

Family Planning Annual Report: 2014 National Summary

v

29. Number of gonorrhea, syphilis, and HIV tests performed, by test type and
region, and number of positive HIV tests, by region: 2014
(Source: FPAR Table 12) .............................................................................................. 48
30. Number and distribution of FTE CSP staff, by type of CSP and region, and
number and distribution of FP encounters, by type of encounter and region:
2014 (Source: FPAR Table 13) ..................................................................................... 51
31. Amount and distribution of Title X project revenues, by revenue source: 2014
(Source: FPAR Table 14) .............................................................................................. 55
32. Amount of Title X project revenues, by revenue source and region: 2014
(Source: FPAR Table 14) .............................................................................................. 58
33. Distribution of Title X project revenues, by revenue source and region: 2014
(Source: FPAR Table 14) .............................................................................................. 59
A–1a. Number and distribution of all family planning users, by region and year:
2004–2014 ................................................................................................................... A-2
A–1b. Number and distribution of all family planning users, by region and year:
2004–2014 ................................................................................................................... A-3
A–2a. Number and distribution of all family planning users, by age and year: 2004–
2014 ............................................................................................................................. A-3
A–2b. Number and distribution of all family planning users, by age and year: 2004–
2014 ............................................................................................................................. A-5
A–3a. Number and distribution of all family planning users, by race and year: 2004–
2014 ............................................................................................................................. A-6
A–3b. Number and distribution of all family planning users, by race and year: 2004–
2014 ............................................................................................................................. A-7
A–4a. Number and distribution of all family planning users, by Hispanic or Latino
ethnicity (all races) and year: 2004–2014 ................................................................... A-8
A–4b. Number and distribution of all family planning users, by Hispanic or Latino
ethnicity (all races) and year: 2004–2014 ................................................................... A-9
A–5a. Number and distribution of all family planning users, by Hispanic or Latino
ethnicity, race, and year: 2004–2014 ........................................................................... A-9
A–5b. Number and distribution of all family planning users, by Hispanic or Latino
ethnicity, race, and year: 2004–2014 ......................................................................... A-11
A–6a. Number and distribution of all family planning users, by income level and
year: 2004–2014 ........................................................................................................ A-12
A–6b. Number and distribution of all family planning users, by income level and
year: 2004–2014 ........................................................................................................ A-13
A–7a. Number and distribution of all family planning users, by health insurance
status and year: 2005–2014 ....................................................................................... A-14
A–7b. Number and distribution of all family planning users, by health insurance
status and year: 2005–2014 ....................................................................................... A-15
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Family Planning Annual Report: 2014 National Summary

A–8a. Number of female family planning users, by primary contraceptive method
and year: 2004–2014 ................................................................................................. A-16
A–8b. Distribution of female family planning users who reported a primary
contraceptive method at exit from the encounter, by primary contraceptive
method and year: 2004–2014 .................................................................................... A-17
A–8c. Number and distribution of female family planning users who reported a
primary contraceptive method at exit from the encounter, by level of method
effectiveness and year: 2004–2014 ........................................................................... A-18
A–9a. Number and percentage of female users who received a Pap test, number of
Pap tests performed, and percentage of Pap tests performed with an ASC or
higher result, by year: 2005–2014 ............................................................................. A-19
A–9b. Number and percentage of female users who received a Pap test, by year:
2005–2014 ................................................................................................................. A-19
A–10a. Number and percentage of female users under 25 tested for chlamydia, by
year: 2005–2014 ........................................................................................................ A-20
A–10b. Number and percentage of female users under 25 tested for chlamydia, by
year: 2005–2014 ........................................................................................................ A-20
A-11a. Number of confidential HIV tests performed and number of tests per 10 users:
2004–2014 ................................................................................................................. A-21
A-11b. Number of confidential HIV tests performed and number of tests per 10 users:
2004–2014 ................................................................................................................. A-21
A–12a. Actual and adjusted (constant 2014$, 2004$, and 1981$) total, Title X, and
Medicaid revenue, by year: 2004–2014 .................................................................... A-22
A–12b. Total, Title X, and Medicaid adjusted (constant 2014$) revenue, by year:
2004–2014 ................................................................................................................. A-23
A–12c. Total actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$)
revenue, by year: 2004–2014 .................................................................................... A-24
A–12d. Title X actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$)
revenue, by year: 2004–2014 .................................................................................... A-25
A–12e. Medicaid actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$)
revenue, by year: 2004–2014 .................................................................................... A-26
A–13a. Amount of Title X project revenue, by revenue source and year: 2004–2014 .......... A-27
A–13b. Distribution of Title X project revenue, by revenue source and year: 2004–
2014 ........................................................................................................................... A-28
A–13c. Amount and distribution of Title X project revenue, by revenue source and
year: 2004–2014 ........................................................................................................ A-29
B–1. Number and distribution of all family planning users, by sex and state, and
distribution of all users, by state: 2014 (Source: FPAR Table 1) ................................ B-2
B–2. Number and distribution of all family planning users, by user income level and
state: 2014 (Source: FPAR Table 4)............................................................................ B-4
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B–3. Number and distribution of all family planning users, by insurance status and
state: 2014 (Source: FPAR Table 5)............................................................................ B-6
B–4. Number and distribution of female family planning users, by effectiveness
level of the users’ primary method at exit from the encounter and state: 2014
(Source: FPAR Table 7) .............................................................................................. B-8
B–5. Number and percentage of female family planning users under 25 years who
were tested for chlamydia, by state: 2014 (Source: FPAR Table 11)........................ B-10

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Executive Summary
The Title X National Family Planning Program, administered by the U.S. Department of
Health and Human Services, Office of Population Affairs (OPA), is the only federal program
dedicated solely to supporting the delivery of family planning and related preventive health
care. The program is designed to provide contraceptive supplies and information to all who
want and need them, with priority given to persons from low-income families. In addition to
offering a broad range of effective and acceptable contraceptive methods on a voluntary and
confidential basis, Title X-funded service sites provide contraceptive education and
counseling; breast and cervical cancer screening; sexually transmitted disease (STD) and
human immunodeficiency virus (HIV) testing, referral, and prevention education; and
pregnancy diagnosis and counseling.1,2 The program is implemented through grants to over
90 public health departments and community health, family planning, and other private
nonprofit agencies. These grants support delivery of Title X services in over 4,100 sites. For
many clients, Title X providers are their only ongoing source of health care and health
education.3 In fiscal year 2014, the Title X program received approximately $286.4 million in
funding.4
Annual submission of the Family Planning Annual Report (FPAR)5 is required of all Title X
services grantees.6,7 The 15-table FPAR provides grantee-level data on the demographic and
social characteristics of Title X clients, their use of family planning and related preventive
health services, and staffing and revenue. FPAR data have multiple uses, which include
monitoring performance and compliance with statutory requirements, fulfilling federal
accountability and performance reporting requirements, and guiding strategic and financial
planning. In addition, OPA uses FPAR data to respond to inquiries from policy makers and
Congress about the program and to estimate the impact of Title X on key reproductive health
outcomes.5
The purpose of the Family Planning Annual Report: 2014 National Summary is to present the
national-, regional-, and state-level findings for the 2014 reporting period (calendar year) and
trends for selected measures. Below we highlight key findings.

KEY 2014 FPAR FINDINGS
A diverse network of public and private nonprofit health and community service
agencies deliver Title X services. In 2014, Title X-funded services were implemented
through grants to 94 agencies: 50 (53%) state and local health departments and 44 (47%)
nonprofit family planning and community health agencies. Title X funds supported a network
of 4,127 service sites operated either by grantees or 1,134 subrecipients in the 50 United
States, the District of Columbia, and eight U.S. territories and Freely Associated States.
Title X providers serve a vulnerable population, most of whom are female, poor,
uninsured, and young. In 2014, Title X-funded providers served more than 4.1 million
family planning users (i.e., clients) through almost 7.2 million family planning encounters. A
family planning user is an individual who has at least one family planning encounter at a
Title X service site during the reporting period. A family planning encounter is a
Family Planning Annual Report: 2014 National Summary

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documented, face-to-face contact between an individual and a family planning provider with
the purpose of delivering family planning and related preventive health services to avoid
unintended pregnancies or achieve intended pregnancies. More than 9 of every 10 users
(91%) were female, 69% were under 30, 69% had family incomes at or below the poverty
level ($23,850 for a family of four in the 48 contiguous states and DC),8 and 54% were
uninsured.
Title X providers serve a racially and ethnically diverse population. Of the more than
4.1 million family planning users served in 2014, 29% self-identified with at least one of the
nonwhite Office of Management and Budget9 race categories (black or African American,
Asian, Native Hawaiian or Pacific Islander, or American Indian or Alaska Native), 30% selfidentified as Hispanic or Latino, and 13% were limited English proficient.
Title X providers offer clients a broad range of effective, medically safe contraceptive
methods approved by the U.S. Food and Drug Administration. In 2014, 84% (3.2 million)
of all female users adopted or continued use of a contraceptive method at exit from their last
encounter. Almost two-thirds of female users exited the encounter with a contraceptive
method that was either highly (13%) or moderately effective (51%) in preventing unintended
pregnancy.10 Nine percent of female users exited the encounter with no primary method
because they were either pregnant or seeking pregnancy.
Title X providers deliver male-focused family planning and reproductive health services
to a growing number of male clients. In 2014, 9% (364,661) of all Title X users were men,
a number that has grown by 49% since 2004. Most male users were in their 20s (49%) or
teens (17%), and 88% (319,279) adopted or continued use of condoms (72%) or other
methods (16%) at exit from their last encounter. In addition, Title X providers tested 66% of
all male users for chlamydia and provided testing for several other STDs, including gonorrhea
(7.4 tests per 10 male users), HIV (5.7 tests per 10 male users), and syphilis (3.3 tests per 10
male users).
Title X-funded cervical and breast cancer screening services contribute to early
detection and management. In 2014, Title X providers conducted Papanicolaou (Pap)
testing on 21% (785,540) of female users. Fourteen percent of almost 813,900 Pap tests
performed had an indeterminate or abnormal result requiring further evaluation and possible
treatment. In addition, providers performed clinical breast exams on 31% (1.3 million) of
female users and referred 4% of those examined for further evaluation based on abnormal
findings.
Title X-funded STD and HIV services prevent transmission and adverse health
consequences. In 2014, Title X providers tested 58% (1.0 million) of female users under 25
for chlamydia. Providers also performed 2.2 million gonorrhea tests (5.4 tests per 10 users),
1.0 million confidential HIV tests (2.5 tests per 10 users), and 590,115 syphilis tests (1.4 tests
per 10 users). Of the confidential HIV tests performed, 2,112 were positive for HIV.
A variety of qualified health providers deliver Title X-funded clinical services. In 2014,
3,066 full-time equivalent (FTE) clinical services providers (CSPs) delivered Title X-funded
care. Nurse practitioners, certified nurse midwives, and physician assistants accounted for
67% of total CSP FTEs, followed by physicians (18%) and registered nurses with an
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Family Planning Annual Report: 2014 National Summary

expanded scope of practice (15%). A CSP attended 71% of the 7.2 million family planning
encounters in 2014.
Six sources account for almost 9 of every 10 dollars in Title X project revenue. In 2014,
Title X grantees reported total project revenue of $1.24 billion to support their approved Title
X services projects. Six sources accounted for 88% of total revenue: Medicaid/Children’s
Health Insurance Program (40%, or $493.1 million), Title X (20%, or $249.5 million), state
governments (10%, or $121.0 million), private third-party payers (8%, or $95.1 million), local
governments (6%, or $80.4 million), and client service fees (4%, or $53.2 million).
Title X project revenue has declined as has the size and reach of the service network. In
2014, Title X projects reported a net decrease of $71.5 million (2014 constant dollars) in total
revenue compared with 2013. The 1-year increase in revenue from private and other thirdparty payer revenue ($24.5 million) was insufficient to offset a total 1-year loss of
$96.1 million from Medicaid ($27.6 million), client service fees ($17.9 million), local
government ($15.6 million), state government ($13.2 million), Title X ($10.2 million), and
block grant and other revenue sources ($11.5 million). This 1-year drop in revenue was
accompanied by declines in the number of clients served (by 428,541), encounters (by
955,119 million), and service sites (by 41).
Apart from a decrease in Title X project revenue, grantees suggested other factors affecting
the demand for and use of Title X-funded services, including changes in clinical guidelines
that have reduced the frequency of recommended preventive health services (e.g., Pap test).
In addition, other health system factors that may have affected Title X services include
electronic health record system implementation and changes in health insurance coverage
status under the Affordable Care Act.

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Family Planning Annual Report: 2014 National Summary

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Introduction

TITLE X NATIONAL FAMILY PLANNING PROGRAM
The National Family Planning Program, created in 1970 and authorized under Title X of the
Public Health Service Act11 is administered by the Office of Population Affairs (OPA), Office
of the Assistant Secretary for Health (OASH), within the U.S. Department of Health and
Human Services (HHS). The Title X program is the only federal program dedicated solely to
the provision of family planning and related preventive health care. The program is designed
to provide contraceptive supplies and information to all who want and need them, with
priority given to persons from low-income families. In addition to offering a broad range of
effective and acceptable contraceptive methods on a voluntary and confidential basis, Title Xfunded centers provide contraceptive education and counseling; breast and cervical cancer
screening; sexually transmitted disease (STD) and human immunodeficiency virus (HIV)
testing, referral, and prevention education; and pregnancy diagnosis and counseling.1,2 By
law, Title X funds cannot be used in programs where abortion is a method of family
planning.1,2 The program is implemented through grants to over 90 public health departments
and community health, family planning, and other private nonprofit agencies. These grants
support delivery of Title X services in over 4,100 sites. For many clients, Title X providers
are their only ongoing source of health care and health education.3 In fiscal year 2014, the
Title X program received approximately $286.4 million in funding.4
OASH facilitates Title X grant application review and sets funding levels in accordance with
federal regulations. The HHS Regional Offices monitor the performance of the Title X
grantees in their respective regions (see Exhibit 1).1

FAMILY PLANNING ANNUAL REPORT
The Family Planning Annual Report (FPAR)5 is the only source of uniform reporting by all
Title X service grantees. The FPAR provides consistent, national-level data on program users,
service providers, utilization of family planning and related preventive health services, and
sources of program revenue. Annual submission of the FPAR is required of all Title X service
grantees for purposes of monitoring and reporting program performance.6,7 The FPAR data
are presented in summary form to protect the confidentiality of the persons who receive Title
X-funded services.2
Title X administrators and grantees use FPAR data to

▪ monitor compliance with statutory requirements;
▪ comply with accountability and federal performance reporting requirements for Title X
family planning funds, including but not limited to the Government Performance and
Results Modernization Act and the Office of Management and Budget (OMB);

▪ guide strategic and financial planning and respond to inquiries from policy makers and
Congress about the program; and

Family Planning Annual Report: 2014 National Summary

1

▪ estimate the impact of Title X-funded activities on key reproductive health outcomes,

including prevention of unintended pregnancy, infertility, and invasive cervical cancer.5

Exhibit 1.

U.S. Department of Health and Human Services regions

The 10 HHS regions (and regional office locations) are as follows:

▪ Region I (Boston, MA)—Connecticut, Maine, Massachusetts, New Hampshire, Rhode
Island, and Vermont

▪ Region II (New York, NY)—New Jersey, New York, Puerto Rico, and the U.S. Virgin
Islands

▪ Region III (Philadelphia, PA)—Delaware; Maryland; Pennsylvania; Virginia;
Washington, DC; and West Virginia

▪ Region IV (Atlanta, GA)—Alabama, Florida, Georgia, Kentucky, Mississippi, North
Carolina, South Carolina, and Tennessee

▪ Region V (Chicago, IL)—Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
▪ Region VI (Dallas, TX)—Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
▪ Region VII (Kansas City, MO)—Iowa, Kansas, Missouri, and Nebraska
▪ Region VIII (Denver, CO)—Colorado, Montana, North Dakota, South Dakota, Utah,
and Wyoming

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Family Planning Annual Report: 2014 National Summary

▪ Region IX (San Francisco, CA)—Arizona, California, Hawaii, Nevada, American
Samoa, Commonwealth of the Northern Mariana Islands, Federated States of
Micronesia, Guam, Republic of the Marshall Islands, and Republic of Palau

▪ Region X (Seattle, WA)—Alaska, Idaho, Oregon, and Washington
REPORT STRUCTURE
The Family Planning Annual Report: 2014 National Summary presents data for the
94 Title X service grantees that submitted an FPAR report for the 2014 reporting period
(January 1, 2014, to December 31, 2014). The National Summary has four sections:
Section 1—Introduction—describes the Title X National Family Planning Program and the
role of FPAR data in managing and monitoring the performance of the Title X program.
Section 2—FPAR Methodology—describes the procedures for collecting, reporting, and
validating FPAR data and presents the definitions for key FPAR terms.
Section 3—Findings—presents the results for each FPAR table and includes a discussion of
national and regional patterns and trends for selected indicators. Section 3 also includes
definitions for table-specific FPAR terms and reporting guidance.
Section 4—References—is a list of National Summary references.
Additional data for the National Summary are included in three appendices: Appendix A
presents trend data for selected indicators for 2004 through 2014 or 2005 through 2014.
Appendix B presents 2014 data for selected indicators by “state,” which includes the 50
states, the District of Columbia, and the eight U.S. territories and Freely Associated States
(American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of
Micronesia, Guam, Puerto Rico, Republic of the Marshall Islands, Republic of Palau, and the
U.S. Virgin Islands). Appendix B exhibits include information on the number and distribution
of Title X family planning users served by sex, income level, health insurance coverage
status, female contraceptive use, and chlamydia testing (females under 25). Appendix C
presents general and table-specific notes about the data presented in this report.

Family Planning Annual Report: 2014 National Summary

3

Key Terms and Definitions for FPAR Reporting
Family Planning User—A family planning user is an individual who has at least one family planning encounter at a
Title X service site during the reporting period. The same individual may be counted as a family planning user only
once during a reporting period.
Family Planning Encounter—A family planning encounter is a documented, face-to-face contact between an
individual and a family planning provider that takes place in a Title X service site. The purpose of a family planning
encounter is to provide family planning and related preventive health services to female and male clients who want to
avoid unintended pregnancies or achieve intended pregnancies. To be counted for purposes of the FPAR, a written
record of the services provided during the family planning encounter must be documented in the client record.
There are two types of family planning encounters at Title X service sites: (1) family planning encounters with a
clinical services provider and (2) family planning encounters with an other services provider. The type of family
planning provider who renders the care, regardless of the services rendered, determines the type of family planning
encounter.
Laboratory tests and related counseling and education, in and of themselves, do not constitute a family planning
encounter unless there is face-to-face contact between the client and provider, the provider documents the encounter
in the client’s record, and the tests are accompanied by family planning counseling or education.
Family Planning Provider—A family planning provider is the individual who assumes primary responsibility for
assessing a client and documenting services in the client record. Providers include those agency staff who exercise
independent judgment as to the services rendered to the client during an encounter. Two general types of providers
deliver Title X family planning services: clinical services providers and other services providers.
Family Planning Service Site—A family planning service site refers to an established unit where grantee or
subrecipient agency staff provide Title X services (clinical, counseling, educational, or referral) that comply with Title
X Program Guidelines1 and where at least some of the encounters between the family planning providers and the
individuals served meet the requirements of a family planning encounter. Established units include clinics, hospital
outpatient departments, homeless shelters, detention and correctional facilities, and other locations where Title X
agency staff provide these family planning services. Service sites may also include equipped mobile vans or schools.
Client Records—Title X projects must establish a medical record for every client who obtains clinical services or
other screening or laboratory services (e.g., blood pressure check, urine-based pregnancy, or STD test). The medical
record contains personal data; a medical history; physical exam data; laboratory test orders, results, and followup;
treatment and special instructions; scheduled revisits; informed consent forms; documentation of refusal of services;
and information on allergies and untoward reactions to identified drug(s). The medical record also contains clinical
findings; diagnostic and therapeutic orders; and documentation of continuing care, referral, and followup. The
medical record allows for entries by counseling and social service staff. The medical record is a confidential record,
accessible only to authorized staff and secured by lock when not in use. The client medical record must contain
sufficient information to identify the client, indicate where and how the client can be contacted, justify the clinical
impression or diagnosis, and warrant the treatment and end results.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 7–10.

4

Family Planning Annual Report: 2014 National Summary

2

FPAR Methodology

DATA COLLECTION
The Title X Family Planning Annual Report (FPAR): Forms and Instructions (Reissued
October 2013)5 consists of 15 reporting tables. OPA instructs grantees to report on the scope
of services or activities that are proposed in their approved grant applications and supported
with Title X grant and related sources of funding. The FPAR instructions provide definitions
for key FPAR terms to ensure uniform reporting by Title X grantees. The key terms describe
the individuals receiving family planning and related preventive health services at Title Xfunded service sites, the range and scope of the services provided, and the family planning
providers that render care.
Throughout this report, we present the instructions for preparing each FPAR table alongside
the table-specific findings. In addition, we use the term “table” when referring to an FPAR
reporting table and “exhibit” when referring to the tabular presentation of the 2014 findings.
Each exhibit identifies the FPAR table that is the source for the data presented.

DATA REPORTING
Title X service grantees are required to submit the FPAR by February 15 for the recently
completed reporting period (January 1 to December 31). In February 2015, 94 grantees
submitted FPARs for the 2014 reporting period. Ninety-six percent (90 reports) of FPARs
were submitted by the due date, and all were submitted using the web-based FPAR Data
System (https://fpar.opa.hhs.gov/).

DATA VALIDATION
FPAR data undergo both electronic and manual validations prior to tabulation. During data
entry, the FPAR Data System performs a set of automated validation procedures that ensure
consistency within and across tables. These validation procedures include calculation of row
and column totals and cross-table comparisons of selected cell values. Each validation
procedure is based on a validation rule that defines which table cells to compare and what
condition or validation test to apply (e.g., =, < , > , ≤ , ≥ ).
After a grantee submits an FPAR, it goes through two levels of review by HHS staff. First,
HHS regional staff review the FPAR and either accept it or return it to the grantee for
correction or clarification. Once the HHS regional staff accept the FPAR, the FPAR Data
Coordinator performs a second and final review, either accepting the FPAR or returning it to
the HHS regional staff and the grantee for correction or clarification. When the FPAR Data
Coordinator has accepted all FPARs, RTI International extracts the FPAR data from the
FPAR Data System database and performs further electronic validations to identify potential
reporting errors and problems, including missing (e.g., ≥ 10% unknown/not reported) and

Family Planning Annual Report: 2014 National Summary

5

out-of-range values for selected measures (e.g., STD test-to-user ratios). RTI also performs a
manual review of all comments entered into the FPAR “Notes” fields.
RTI summarizes the results of the electronic and manual validations in a grantee-specific
report, compiled by region, which RTI sends to the FPAR Data Coordinator for followup and
resolution. Once HHS staff address all outstanding validation issues in the FPAR Data
System, RTI extracts the final data file for tabulation and analysis.

Guidance for Reporting User Demographic Profile Data in FPAR Tables 1 through 3
In FPAR Tables 1, 2, and 3, grantees report information on the demographic profile of family planning users,
including age and sex (Table 1) and race and ethnicity (Tables 2 and 3).
In FPAR Table 1, grantees report the unduplicated number of family planning users by age group and sex,
categorizing the users based on their age as of June 30 of the reporting period. The FPAR instructions provide the
following guidance for reporting this information:
Age Group—Categorize family planning users based on their age as of June 30 of the reporting period.
In FPAR Tables 2 and 3, grantees report the unduplicated number of female (Table 2) and male (Table 3) family
planning users by race and ethnicity. The FPAR instructions provide the following guidance for reporting this
information:
Race and Ethnicity—The categories for reporting ethnicity and race in the FPAR conform to the Office of
Management and Budget (OMB) 1997 Revisions to the Standards for the Classification of Federal Data on Race
and Ethnicity9 and are used by other HHS programs and compilers of such national data sets as the National
Survey of Family Growth. If an agency wants to collect data for ethnicity or race subcategories, the agency must be
able to aggregate the data reported into the OMB minimum standard set of ethnicity and race categories. OMB
encourages self-identification of race. When respondents are allowed to self-identify or self-report their race,
agencies should adopt a method that allows respondents to mark or select more than one of the five minimum race
categories.
The two minimum OMB categories for reporting ethnicity are as follows:
Hispanic or Latino (All Races)—A person of Cuban, Mexican, Puerto Rican, South or Central American, or
other Spanish culture or origin, regardless of race.
Not Hispanic or Latino (All Races)—A person not of Cuban, Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin, regardless of race.
The five minimum OMB categories for reporting race are as follows:
American Indian or Alaska Native—A person having origins in any of the original peoples of North and South
America (including Central America) and who maintains tribal affiliation or community attachment.
Asian—A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, and Vietnam.
Black or African American—A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander—A person having origins in any of the original peoples of Hawaii,
Guam, Samoa, or other Pacific Islands.
White—A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 15–17, A-1–A-2.

6

Family Planning Annual Report: 2014 National Summary

3

Findings

GRANTEE PROFILE
In 2014, Title X-funded services were implemented through grants to 94 agencies: 50 (53%)
state and local health departments and 44 (47%) nonprofit family planning and community
health agencies. This funding supported a service network that included 1,134 subrecipients
(subcontractors) and 4,127 service sites in the 50 United States, the District of Columbia, and
the eight U.S. territories and Freely Associated States (Exhibit 2).
In 2014, the Title X program had 1 fewer grantee (94 in 2014 vs. 95 in 2013), 47 fewer
subrecipients (1,181 vs. 1,134), and 41 fewer service sites (4,127 vs. 4,168) than in 2013. All
but three regions (I, IV, and VIII) reported declines in the numbers of subrecipients (1 to 45)
and service sites (5 to 129) from 2013 to 2014 (Exhibit 2).

Exhibit 2.

Number of and percentage change in grantees, subrecipients, and service sites, by year
and region: 2013–2014 (Source: FPAR Grantee Profile Cover Sheet)

Network
Feature

All
Regions

Region
I

Region
II

Region
III

Region
IV

Region
V

Region
VI

Region
VII

Region
VIII

Region
IX

Region
X

Grantees
2014

94

12

6

10

14

10

6

5

6

17

8

2013

95

11

6

10

13

11

7

5

6

18

8

Difference

−1

1

0

0

1

−1

−1

0

0

−1

0

% Change

−1%

9%

0%

0%

8%

−9%

−14%

0%

0%

−6%

0%

2014

1,134

67

70

258

253

120

45

93

74

95

59

2013

1,181

66

71

271

214

133

90

97

74

105

60

Difference

−47

1

−1

−13

39

−13

−45

−4

0

−10

−1

% Change

−4%

2%

−1%

−5%

18%

−10%

−50%

−4%

0%

−10%

−2%

2014

4,127

233

251

615

1,183

340

442

223

182

441

217

2013

4,168

225

256

627

1,019

362

571

242

182

460

224

Difference

−41

8

−5

−12

164

−22

−129

−19

0

−19

−7

% Change

−1%

4%

−2%

−2%

16%

−6%

−23%

−8%

0%

−4%

−3%

Subrecipients

Service Sites

Family Planning Annual Report: 2014 National Summary

7

FAMILY PLANNING USER DEMOGRAPHIC PROFILE
Total Users (Exhibit 3)

In 2014, Title X-funded sites served 4.1 million family planning users, a number that was 9%
(or 428,541 users) lower than in 2013. Grantees in Regions IV and IX served the most
users—19% and 28%, respectively—while Regions II, III, V, and VI each served from 7% to
11%. Compared with 2013, 9 of 10 regions reported declines in the number of users served in
2014 that ranged from 2,814 (X) to 119,471 (IX) users (Exhibit 3). On average, the number
of users per service site decreased by 93, from 1,094 in 2013 to 1,001 in 2014 (not shown).
Exhibit 3.

Number, distribution, and percentage change in number of all family planning users, by
year and region: 2013–2014 (Source: FPAR Table 1)
Region
IX

Region
X

All
Regions

Region
I

Region
II

Region
III

Region
IV

Region
V

Region
VI

Region
VII

Region
VIII

2014

4,129,283

184,005

429,409

468,157

770,501

377,552

298,294

148,405

137,509

1,149,781 165,670

2013

4,557,824

182,684

470,836

520,403

852,400

401,935

372,296

167,286

152,248

1,269,252 168,484

Difference

−428,541

1,321

−41,427

−52,246

−81,899

−24,383

−74,002

−18,881

−14,739

−119,471

−2,814

% Change

−9%

1%

−9%

−10%

−10%

−6%

−20%

−11%

−10%

−9%

−2%

2014

100%

4%

10%

11%

19%

9%

7%

4%

3%

28%

4%

2013

100%

4%

10%

11%

19%

9%

8%

4%

3%

28%

4%

Users
Number

Distribution

Note: Due to rounding, percentages may not sum to 100%.

In 2014, the number of family planning users served (4.1 million) was 19% (or 938,502
users) lower than the number served in 2004 (5.1 million) and 21% (or 1.1 million) lower
than the highest number of users (5.2 million) ever served by the program in 2010 (Exhibit
A–1a in Appendix A).
Users by Sex (Exhibits 4 and 5)

Of the 4.1 million users served in 2014, 91% (3.8 million) were female and 9% (364,661)
were male (Exhibits 4 and 5). Additional results include the following:

▪ By region, 86% (VIII) to 97% (IV) of total users were female, while 3% (IV) to 14%
(VIII) were male (Exhibits 4 and 5).

▪ By state, the percentage of total users who were female ranged from 73% to 99%, and
the percentage who were male ranged from 1% to 27% (Exhibit B–1 in Appendix B).

In 2014, the percentage of users who were male (9%) was 4 points higher than in 2004 (5%).
Numerically, the number of female users decreased 22% from 2004 (4.8 million) to 2014 (3.8
million), while the number of male users grew 49%, from 244,381 in 2004 to 364,661 in 2014
(Exhibits A–1a and A–1b).

8

Family Planning Annual Report: 2014 National Summary

Users by Age (Exhibits 4 and 5)

In 2014, 18% (748,899) of family planning users were under 20, 50% (2.1 million) were 20 to
29, and 32% (1.3 million) were 30 or over (Exhibits 4 and 5). Additional results include the
following:

▪ By sex, about the same percentages of female and male users were in their teens (17%
to 18%) and 20s (49% to 51%), while a slightly higher percentage of male (34%) than
female (31%) users was 30 or over.

▪ By region, there was slightly more variation in the age distribution of male than female
users.

– Among female users, 16% (II and IX) to 23% (VIII) were in their teens, 47% (I and
VI) to 53% (IX) were in their 20s, and 27% (VIII) to 34% (II and VI) were 30 or
over.
– Among male users, 11% (X) to 26% (III) of male users were in their teens, 40% (IV)
to 55% (VII) were in their 20s, and 29% (II) to 44% (X) were 30 or over.
Since 2004, the percentage of family planning users under 25 decreased 13 points, from 59%
(2004) to 46% (2014), with users under 20 accounting for most of this decline (27% in 2004
vs. 18% in 2014) (Exhibits A–2a and A–2b).

▪ Numerically, the number of teenage users decreased 46%, from 1.4 million (2004) to
748,899 (2014), while the number of users 20 to 24 decreased 27%, from 1.6 million
(2004) to 1.2 million (2014).

▪ In contrast, the percentage of users over 24 increased from 41% (2004) to 54% (2014);

numerically this represented a 7% increase, from 2.1 million users (2004) to 2.2 million
(2014).

Family Planning Annual Report: 2014 National Summary

9

Exhibit 4.

Number of all family planning users, by sex, age, and region: 2014 (Source: FPAR Table 1)

10

Age Group (Years)

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Female Users
Under 15

36,626

2,470

3,015

5,889

8,428

3,346

3,706

1,556

1,470

15 to 17

274,520

14,235

24,677

36,098

53,869

27,356

21,055

11,148

10,973

59,902

15,207

18 to 19

375,973

15,680

35,014

41,395

72,343

37,803

26,832

14,449

15,252

100,543

16,662

20 to 24

1,071,463

41,659

105,236

110,686

210,444

105,346

72,580

38,203

36,418

308,379

42,512

25 to 29

832,106

32,953

91,151

88,530

168,126

75,517

56,479

27,564

23,013

235,940

32,833

30 to 34

525,675

20,791

59,366

57,800

111,695

45,578

41,134

18,681

14,566

135,011

21,053

35 to 39

304,474

13,174

35,499

33,649

62,690

25,171

25,607

11,023

8,327

77,114

12,220

40 to 44

183,220

9,492

20,627

20,170

34,028

14,156

14,385

7,002

4,837

51,625

6,898

Over 44

160,565

9,720

17,685

20,775

25,013

10,716

11,249

7,087

3,984

49,490

4,846

3,764,622

160,174

392,270

414,992

746,636

344,989

273,027

136,713

118,840

1,023,070

153,911

Subtotal
Male Users
Under 15

5,066

1,680

Family Planning Annual Report: 2014 National Summary

9,237

1,125

877

2,288

1,662

515

955

158

435

1,143

79

15 to 17

24,319

3,123

2,509

6,322

1,698

1,647

1,042

621

1,057

5,741

559

18 to 19

28,224

1,805

3,170

5,047

1,634

2,480

1,880

963

1,402

9,213

630

20 to 24

98,485

5,605

11,345

12,959

5,219

9,853

6,355

3,652

5,287

35,482

2,728

25 to 29

80,024

4,484

8,541

9,185

4,393

7,391

4,983

2,739

4,419

31,315

2,574

30 to 34

47,335

2,668

4,720

5,482

2,952

4,179

3,413

1,559

2,503

17,950

1,909

35 to 39

26,965

1,559

2,274

3,388

2,035

2,339

2,183

795

1,408

9,806

1,178

40 to 44

17,735

1,244

1,296

2,357

1,491

1,515

1,561

501

859

6,132

779

Over 44

32,337

2,218

2,407

6,137

2,781

2,644

2,895

704

1,299

9,929

1,323

Subtotal

364,661

23,831

37,139

53,165

23,865

32,563

25,267

11,692

18,669

126,711

11,759

All Users
Under 15

45,863

3,595

3,892

8,177

10,090

3,861

4,661

1,714

1,905

6,209

1,759

15 to 17

298,839

17,358

27,186

42,420

55,567

29,003

22,097

11,769

12,030

65,643

15,766

18 to 19

404,197

17,485

38,184

46,442

73,977

40,283

28,712

15,412

16,654

109,756

17,292

20 to 24

1,169,948

47,264

116,581

123,645

215,663

115,199

78,935

41,855

41,705

343,861

45,240

25 to 29

912,130

37,437

99,692

97,715

172,519

82,908

61,462

30,303

27,432

267,255

35,407

30 to 34

573,010

23,459

64,086

63,282

114,647

49,757

44,547

20,240

17,069

152,961

22,962

35 to 39

331,439

14,733

37,773

37,037

64,725

27,510

27,790

11,818

9,735

86,920

13,398

40 to 44

200,955

10,736

21,923

22,527

35,519

15,671

15,946

7,503

5,696

57,757

7,677

Over 44

192,902

11,938

20,092

26,912

27,794

13,360

14,144

7,791

5,283

59,419

6,169

4,129,283

184,005

429,409

468,157

770,501

377,552

298,294

148,405

137,509

1,149,781

165,670

Total All Users

Family Planning Annual Report: 2014 National Summary

Exhibit 5.

Distribution of all family planning users, by sex, age, and region: 2014 (Source: FPAR Table 1)

Age Group (Years)

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Female Users
Under 15

1%

2%

1%

1%

1%

1%

1%

1%

1%

0%†

1%

15 to 17

7%

9%

6%

9%

7%

8%

8%

8%

9%

6%

10%

18 to 19

10%

10%

9%

10%

10%

11%

10%

11%

13%

10%

11%

20 to 24

28%

26%

27%

27%

28%

31%

27%

28%

31%

30%

28%

25 to 29

22%

21%

23%

21%

23%

22%

21%

20%

19%

23%

21%

30 to 34

14%

13%

15%

14%

15%

13%

15%

14%

12%

13%

14%

35 to 39

8%

8%

9%

8%

8%

7%

9%

8%

7%

8%

8%

40 to 44

5%

6%

5%

5%

5%

4%

5%

5%

4%

5%

4%

Over 44

4%

6%

5%

5%

3%

3%

4%

5%

3%

5%

3%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%
1%

Subtotal
Male Users
Under 15

3%

5%

2%

4%

7%

2%

4%

1%

2%

1%

15 to 17

7%

13%

7%

12%

7%

5%

4%

5%

6%

5%

5%

18 to 19

8%

8%

9%

9%

7%

8%

7%

8%

8%

7%

5%

20 to 24

27%

24%

31%

24%

22%

30%

25%

31%

28%

28%

23%

25 to 29

22%

19%

23%

17%

18%

23%

20%

23%

24%

25%

22%

30 to 34

13%

11%

13%

10%

12%

13%

14%

13%

13%

14%

16%

35 to 39

7%

7%

6%

6%

9%

7%

9%

7%

8%

8%

10%

40 to 44

5%

5%

3%

4%

6%

5%

6%

4%

5%

5%

7%

Over 44

9%

9%

6%

12%

12%

8%

11%

6%

7%

8%

11%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Subtotal
All Users
Under 15

11

1%

2%

1%

2%

1%

1%

2%

1%

1%

1%

1%

15 to 17

7%

9%

6%

9%

7%

8%

7%

8%

9%

6%

10%

18 to 19

10%

10%

9%

10%

10%

11%

10%

10%

12%

10%

10%

20 to 24

28%

26%

27%

26%

28%

31%

26%

28%

30%

30%

27%

25 to 29

22%

20%

23%

21%

22%

22%

21%

20%

20%

23%

21%

30 to 34

14%

13%

15%

14%

15%

13%

15%

14%

12%

13%

14%

35 to 39

8%

8%

9%

8%

8%

7%

9%

8%

7%

8%

8%

40 to 44

5%

6%

5%

5%

5%

4%

5%

5%

4%

5%

5%

Over 44

5%

6%

5%

6%

4%

4%

5%

5%

4%

5%

4%

Total All Users

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Female Users

91%

87%

91%

89%

97%

91%

92%

92%

86%

89%

93%

9%

13%

9%

11%

3%

9%

8%

8%

14%

11%

7%

Male Users

Note: Due to rounding, percentages may not sum to 100%.
† Percentage is less than 0.5%.

Users by Race (Exhibits 6 through 14)

In 2014, 54% (2.2 million) of all family planning users identified themselves as white, 21%
(863,136) as black or African American, 3% (128,797) as Asian, and 1% as either Native
Hawaiian or Other Pacific Islander (39,266) or American Indian or Alaska Native (29,327).
Four percent (153,907) of all users self-identified with two or more of the five minimum race
categories specified by OMB,9 and race was either unknown or not reported for 16%
(676,003) (Exhibit 6). Additional results include the following:

▪ By sex, the racial composition of female (Exhibits 7, 11, and 12) and male users

(Exhibits 8, 13, and 14) differed slightly in terms of the percentages in each group that
self-identified as white (55% of female users vs. 48% of male users), black or African
American (20% vs. 26%), and Asian (3% vs. 2%). Race was unknown or not reported
for a slightly higher percentage of male (19%) than female (16%) users.

▪ By region, the distribution of users by race varied widely (Exhibits 9 and 10).
– From 41% (II) to 77% (VIII) of users self-identified as white, 4% (X) to 36% (IV)
self-identified as black or African American, and 1% (VII) to 7% (I) self-identified
with two or more of the five OMB race categories. Race was unknown or not
reported for 3% (IV) to 30% (IX) of users.
– Region IX, which includes California, Hawaii, and the Pacific territories and Freely
Associated States, had the highest percentages of users identifying themselves as
Asian (6%) and Native Hawaiian or Other Pacific Islander (3%).

▪ By ethnicity, Hispanic or Latino users accounted for a majority of users with unknown
race data. Among female and male users with an unknown race, 70% (427,396) of
females (Exhibit 7) and 66% (45,712) of males (Exhibit 8) were Hispanic or Latino.

In 2014, the percentage distribution of family planning users by race showed little change
compared with 2004, except in the percentage who self-identified as white, which declined
from 64% in 2004 to 54% in 2014. This decline was offset by increases in the percentages of
users for whom race was unknown (12% in 2004 vs. 16% in 2014) and who self-identified
with two or more OMB race categories (new category added in 2005) (Exhibits A–3a and A–
3b).
Users by Ethnicity (Exhibits 6 through 14)

In 2014, 30% (1.2 million) of users identified themselves as Hispanic or Latino (Exhibit 6).

▪ By sex, 30% (1.1 million) of female users and 28% (100,607) of male users self-

identified as Hispanic or Latino, while ethnicity was unknown or not reported for 2% of
female users and 4% of male users (Exhibits 7 and 8).

▪ By region, Regions II, VI, and IX reported the highest percentages of female (39% to

49%) and male (33% to 43%) users who self-identified as Hispanic or Latino (Exhibits
11, 12, 13, and 14).

In 2014, the percentage of users who self-identified as Hispanic or Latino was 30% compared
with 23% in 2004. Numerically, the number of Hispanic or Latino users grew 7%, from 1.16
million (2004) to 1.24 million (2014) (Exhibits A–4a and A–4b).
12

Family Planning Annual Report: 2014 National Summary

Exhibit 6.

Number and distribution of all family planning users, by race and ethnicity: 2014
(Source: FPAR Tables 2 and 3)
Hispanic
or Latino

Race

Not
Hispanic or
Latino

Ethnicity
UK/NR

Total

%
Hispanic
or Latino

%
Not Hispanic
or Latino

%
Ethnicity
UK/NR

%
Total

Am Indian/Alaska Native

8,240

20,388

699

29,327

0%†

0%†

0%†

1%

Asian

6,008

119,454

3,335

128,797

0%†

3%

0%†

3%

29,621

816,061

17,454

863,136

1%

20%

0%†

21%

Black/African American
Nat Hawaiian/Pac Island
White
More than one race
Unknown/not reported
Total All Users

5,438

32,650

1,178

39,266

1%

0%†

1%

617,516

1,583,629

37,702

2,238,847

15%

0%†

38%

1%

54%

97,721

50,658

5,528

153,907

2%

1%

0%†

4%

473,108

163,165

39,730

676,003

11%

4%

1%

16%

1,237,652

2,786,005

105,626

4,129,283

30%

67%

3%

100%

Am Indian/Alaska Native=American Indian or Alaska Native. Nat Hawaiian/Pac Island=Native Hawaiian or Other Pacific Islander.
Note: Due to rounding, percentages may not sum to 100%.
†

Percentage is less than 0.5%.

Exhibit 7.

Number and distribution of female family planning users, by race and ethnicity: 2014
(Source: FPAR Table 2)
Hispanic
or Latino

Race

Not
Hispanic or
Latino

Ethnicity
UK/NR

Total

%
Hispanic
or Latino

%
Not Hispanic
or Latino

%
Ethnicity
UK/NR

%
Total

Am Indian/Alaska Native

7,498

18,403

594

26,495

0%†

0%†

0%†

1%

Asian

5,605

111,392

3,045

120,042

0%†

3%

0%†

3%

Black/African American

26,746

728,166

14,169

769,081

1%

19%

0%†

20%

Nat Hawaiian/Pac Island

5,012

30,090

1,077

36,179

0%†

1%

0%†

1%

573,859

1,458,046

32,946

2,064,851

15%

39%

1%

55%

White
More than one race
Unknown/not reported
Total Female Users

90,929

45,513

4,746

141,188

2%

1%

0%†

4%

427,396

144,399

34,991

606,786

11%

4%

1%

16%

1,137,045

2,536,009

91,568

3,764,622

30%

67%

2%

100%

Am Indian/Alaska Native=American Indian or Alaska Native. Nat Hawaiian/Pac Island=Native Hawaiian or Other Pacific Islander.
Note: Due to rounding, percentages may not sum to 100%.
†

Percentage is less than 0.5%.

Exhibit 8.

Number and distribution of male family planning users, by race and ethnicity: 2014
(Source: FPAR Table 3)

Race
Am Indian/Alaska Native
Asian
Black/African American
Nat Hawaiian/Pac Island
White
More than one race
Unknown/not reported
Total Male Users

Hispanic
or Latino
742

Not
Hispanic or
Latino

Ethnicity
UK/NR

1,985

105

Total

%
Hispanic
or Latino

2,832

0%†

%
Not Hispanic
or Latino

%
Ethnicity
UK/NR

1%

0%†

%
Total
1%

403

8,062

290

8,755

0%†

2%

0%†

2%

2,875

87,895

3,285

94,055

1%

24%

1%

26%

426

2,560

101

3,087

1%

0%†

1%

43,657

125,583

4,756

173,996

12%

0%†

34%

1%

48%

6,792

5,145

782

12,719

2%

1%

0%†

3%

45,712

18,766

4,739

69,217

13%

5%

1%

19%

100,607

249,996

14,058

364,661

28%

69%

4%

100%

Am Indian/Alaska Native=American Indian or Alaska Native. Nat Hawaiian/Pac Island=Native Hawaiian or Other Pacific Islander.
Note: Due to rounding, percentages may not sum to 100%.
†

Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

13

Exhibit 9.

Number of all family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Tables 2 and 3)

14

Race and Ethnicity
American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII Region VIII

Region IX

Region X

Family Planning Annual Report: 2014 National Summary

8,240
20,388
699
29,327

152
438
11
601

410
713
20
1,143

307
1,864
62
2,233

1,336
2,095
6
3,437

637
1,535
151
2,323

420
3,977
23
4,420

203
911
88
1,202

325
1,674
82
2,081

3,951
5,140
249
9,340

499
2,041
7
2,547

Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

6,008
119,454
3,335
128,797

328
8,825
38
9,191

271
12,611
85
12,967

193
7,508
308
8,009

317
7,568
37
7,922

121
4,896
386
5,403

120
2,227
84
2,431

39
2,143
250
2,432

58
2,087
98
2,243

4,473
66,105
2,027
72,605

88
5,484
22
5,594

Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

29,621
816,061
17,454
863,136

3,773
23,919
192
27,884

12,611
97,497
484
110,592

2,447
147,570
6,317
156,334

3,468
274,629
1,221
279,318

1,204
90,139
3,210
94,553

1,438
66,627
120
68,185

314
20,072
1,854
22,240

197
6,160
281
6,638

3,870
83,324
3,742
90,936

299
6,124
33
6,456

5,438
32,650
1,178
39,266

406
153
2
561

905
697
8
1,610

553
569
38
1,160

723
799
7
1,529

142
314
26
482

154
651
7
812

72
225
12
309

51
541
10
602

2,066
27,546
894
30,506

366
1,155
174
1,695

White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

617,516
1,583,629
37,702
2,238,847

17,290
85,874
2,692
105,856

52,317
123,383
488
176,188

30,148
196,225
5,583
231,956

91,529
331,276
1,566
424,371

30,574
182,498
7,568
220,640

108,886
95,639
339
204,864

19,390
90,666
3,300
113,356

21,195
82,078
2,917
106,190

228,003
294,086
12,866
534,955

18,184
101,904
383
120,471

More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

97,721
50,658
5,528
153,907

7,267
4,693
115
12,075

16,517
1,349
69
17,935

5,091
2,037
188
7,316

24,281
5,709
48
30,038

1,705
3,755
731
6,191

2,153
3,675
22
5,850

753
1,354
46
2,153

994
1,461
107
2,562

38,065
23,859
4,048
65,972

895
2,766
154
3,815

Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

473,108
163,165
39,730
676,003

10,855
14,059
2,923
27,837

82,266
25,993
715
108,974

32,757
21,895
6,497
61,149

12,609
4,146
7,131
23,886

25,608
18,502
3,850
47,960

8,256
2,692
784
11,732

2,953
2,565
1,195
6,713

13,130
2,920
1,143
17,193

272,925
57,224
15,318
345,467

11,749
13,169
174
25,092

1,237,652
2,786,005
105,626
4,129,283

40,071
137,961
5,973
184,005

165,297
262,243
1,869
429,409

71,496
377,668
18,993
468,157

134,263
626,222
10,016
770,501

59,991
301,639
15,922
377,552

121,427
175,488
1,379
298,294

23,724
117,936
6,745
148,405

35,950
96,921
4,638
137,509

553,353
557,284
39,144
1,149,781

32,080
132,643
947
165,670

Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

Family Planning Annual Report: 2014 National Summary

Exhibit 10. Distribution of all family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Tables 2 and 3)
Race and Ethnicity
American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

All Regions

15

Percentage is less than 0.5%.

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

0%†
0%†
0%†
1%

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
2%

0%†
0%†
0%†
1%

0%†
1%
0%†
2%

0%†
3%
0%†
3%

0%†
5%
0%†
5%

0%†
3%
0%†
3%

0%†
2%
0%†
2%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
2%

0%†
2%
0%†
2%

0%†
6%
0%†
6%

0%†
3%
0%†
3%

1%
20%
0%†
21%

2%
13%
0%†
15%

3%
23%
0%†
26%

0%†
36%
0%†
36%

0%†
24%
1%
25%

0%†
22%
0%†
23%

0%†
14%
1%
15%

0%†
4%
0%†
5%

0%†
7%
0%†
8%

0%†
4%
0%†
4%

0%†
1%
0%†
1%

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
2%
0%†
3%

0%†
1%
0%†
1%

15%
38%
1%
54%
2%
1%
0%†
4%

9%
47%
1%
58%
4%
3%
0%†
7%

12%
29%
0%†
41%
4%
0%†
0%†
4%

1%
32%
1%
33%
0%†
0%†
0%†
0%†
6%
42%
1%
50%
1%
0%†
0%†
2%

12%
43%
0%†
55%
3%
1%
0%†
4%

8%
48%
2%
58%
0%†
1%
0%†
2%

37%
32%
0%†
69%

13%
61%
2%
76%

1%
1%
0%†
2%

1%
1%
0%†
1%

15%
60%
2%
77%
1%
1%
0%†
2%

20%
26%
1%
47%
3%
2%
0%†
6%

11%
4%
1%
16%

6%
8%
2%
15%

19%
6%
0%†
25%

7%
5%
1%
13%

2%
1%
1%
3%

7%
5%
1%
13%

3%
1%
0%†
4%

2%
2%
1%
5%

10%
2%
1%
13%

24%
5%
1%
30%

30%
67%
3%
100%

22%
75%
3%
100%

38%
61%
0%†
100%

15%
81%
4%
100%

17%
81%
1%
100%

16%
80%
4%
100%

41%
59%
0%†
100%

16%
79%
5%
100%

26%
70%
3%
100%

48%
48%
3%
100%

Note: Due to rounding, percentages may not sum to 100%.
†

Region I

11%
62%
0%†
73%
1%
2%
0%†
2%
7%
8%
0%†
15%
19%
80%
1%
100%

Exhibit 11. Number of female family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Table 2)

16

Race and Ethnicity
American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Family Planning Annual Report: 2014 National Summary

7,498
18,403
594
26,495

128
377
11
516

387
654
11
1,052

256
1,527
48
1,831

1,310
2,059
5
3,374

601
1,376
131
2,108

399
3,813
21
4,233

186
823
83
1,092

256
1,484
63
1,803

3,501
4,467
214
8,182

474
1,823
7
2,304

Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

5,605
111,392
3,045
120,042

307
8,426
31
8,764

244
11,764
76
12,084

185
6,995
272
7,452

314
7,129
36
7,479

117
4,568
338
5,023

111
2,025
77
2,213

39
2,038
246
2,323

54
1,894
92
2,040

4,152
61,264
1,856
67,272

82
5,289
21
5,392

Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

26,746
728,166
14,169
769,081

3,287
19,610
150
23,047

11,612
88,359
391
100,362

2,039
124,756
4,660
131,455

3,362
263,352
1,037
267,751

1,074
78,771
2,802
82,647

1,303
57,324
96
58,723

291
16,687
1,762
18,740

155
4,180
206
4,541

3,339
69,829
3,035
76,203

284
5,298
30
5,612

5,012
30,090
1,077
36,179

318
128
2
448

847
626
6
1,479

477
526
28
1,031

707
783
7
1,497

127
297
23
447

147
623
7
777

65
209
12
286

47
465
8
520

1,916
25,352
810
28,078

361
1,081
174
1,616

White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

573,859
1,458,046
32,946
2,064,851

15,179
74,351
2,433
91,963

49,595
112,131
392
162,118

27,882
181,233
4,789
213,904

89,838
322,718
1,436
413,992

28,891
169,353
6,859
205,103

100,315
90,003
283
190,601

18,495
84,617
3,010
106,122

19,240
71,323
2,493
93,056

206,861
258,116
10,912
475,889

17,563
94,201
339
112,103

More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

90,929
45,513
4,746
141,188

6,553
4,163
95
10,811

15,795
1,229
61
17,085

4,415
1,795
143
6,353

23,886
5,410
44
29,340

1,588
3,437
661
5,686

2,038
3,557
18
5,613

718
1,245
42
2,005

877
1,261
87
2,225

34,204
20,958
3,441
58,603

855
2,458
154
3,467

Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

427,396
144,399
34,991
606,786

9,407
12,492
2,726
24,625

74,602
22,969
519
98,090

29,329
18,510
5,127
52,966

12,172
3,963
7,068
23,203

23,911
16,654
3,410
43,975

7,663
2,512
692
10,867

2,779
2,334
1,032
6,145

11,400
2,285
970
14,655

245,114
50,452
13,277
308,843

11,019
12,228
170
23,417

1,137,045
2,536,009
91,568
3,764,622

35,179
119,547
5,448
160,174

153,082
237,732
1,456
392,270

64,583
335,342
15,067
414,992

131,589
605,414
9,633
746,636

56,309
274,456
14,224
344,989

111,976
159,857
1,194
273,027

22,573
107,953
6,187
136,713

32,029
82,892
3,919
118,840

499,087
490,438
33,545
1,023,070

30,638
122,378
895
153,911

Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

Family Planning Annual Report: 2014 National Summary

Exhibit 12. Distribution of female family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Table 2)
Race and Ethnicity

All Regions

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

0%†
0%†
0%†
1%

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
1%

0%†
1%
0%†
2%

0%†
1%
0%†
1%

0%†
1%
0%†
2%

0%†
0%†
0%†
1%

0%†
1%
0%†
1%

Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

0%†
3%
0%†
3%

0%†
5%
0%†
5%

0%†
3%
0%†
3%

0%†
2%
0%†
2%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
2%

0%†
2%
0%†
2%

0%†
6%
0%†
7%

0%†
3%
0%†
4%

1%
19%
0%†
20%

2%
12%
0%†
14%

3%
23%
0%†
26%

0%†
30%
1%
32%

0%†
35%
0%†
36%

0%†
23%
1%
24%

0%†
21%
0%†
22%

0%†
12%
1%
14%

0%†
4%
0%†
4%

0%†
7%
0%†
7%

0%†
3%
0%†
4%

0%†
1%
0%†
1%

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%†
0%†

0%†
2%
0%†
3%

0%†
1%
0%†
1%

Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

15%
39%
1%
55%
2%
1%
0%†
4%

17

Percentage is less than 0.5%.

9%
46%
2%
57%
4%
3%
0%†
7%

13%
29%
0%†
41%
4%
0%†
0%†
4%

7%
44%
1%
52%
1%
0%†
0%†
2%

12%
43%
0%†
55%
3%
1%
0%†
4%

8%
49%
2%
59%
0%†
1%
0%†
2%

37%
33%
0%†
70%

14%
62%
2%
78%

1%
1%
0%†
2%

1%
1%
0%†
1%

16%
60%
2%
78%
1%
1%
0%†
2%

20%
25%
1%
47%
3%
2%
0%†
6%

11%
4%
1%
16%

6%
8%
2%
15%

19%
6%
0%†
25%

7%
4%
1%
13%

2%
1%
1%
3%

7%
5%
1%
13%

3%
1%
0%†
4%

2%
2%
1%
4%

10%
2%
1%
12%

24%
5%
1%
30%

30%
67%
2%
100%

22%
75%
3%
100%

39%
61%
0%†
100%

16%
81%
4%
100%

18%
81%
1%
100%

16%
80%
4%
100%

41%
59%
0%†
100%

17%
79%
5%
100%

27%
70%
3%
100%

49%
48%
3%
100%

Note: Due to rounding, percentages may not sum to 100%.
†

Region I

American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

11%
61%
0%†
73%
1%
2%
0%†
2%
7%
8%
0%†
15%
20%
80%
1%
100%

Exhibit 13. Number of male family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Table 3)

18

Race and Ethnicity

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

742
1,985
105
2,832

24
61
0
85

23
59
9
91

51
337
14
402

26
36
1
63

36
159
20
215

21
164
2
187

17
88
5
110

69
190
19
278

450
673
35
1,158

25
218
0
243

Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

403
8,062
290
8,755

21
399
7
427

27
847
9
883

8
513
36
557

3
439
1
443

4
328
48
380

9
202
7
218

0
105
4
109

4
193
6
203

321
4,841
171
5,333

6
195
1
202

2,875
87,895
3,285
94,055

486
4,309
42
4,837

999
9,138
93
10,230

408
22,814
1,657
24,879

106
11,277
184
11,567

130
11,368
408
11,906

135
9,303
24
9,462

23
3,385
92
3,500

42
1,980
75
2,097

531
13,495
707
14,733

15
826
3
844

426
2,560
101
3,087

88
25
0
113

58
71
2
131

76
43
10
129

16
16
0
32

15
17
3
35

7
28
0
35

7
16
0
23

4
76
2
82

150
2,194
84
2,428

5
74
0
79

White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

43,657
125,583
4,756
173,996

2,111
11,523
259
13,893

2,722
11,252
96
14,070

2,266
14,992
794
18,052

1,691
8,558
130
10,379

1,683
13,145
709
15,537

8,571
5,636
56
14,263

895
6,049
290
7,234

1,955
10,755
424
13,134

21,142
35,970
1,954
59,066

621
7,703
44
8,368

More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

6,792
5,145
782
12,719

714
530
20
1,264

722
120
8
850

676
242
45
963

395
299
4
698

117
318
70
505

115
118
4
237

35
109
4
148

117
200
20
337

3,861
2,901
607
7,369

40
308
0
348

Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

45,712
18,766
4,739
69,217

1,448
1,567
197
3,212

7,664
3,024
196
10,884

3,428
3,385
1,370
8,183

437
183
63
683

1,697
1,848
440
3,985

593
180
92
865

174
231
163
568

1,730
635
173
2,538

27,811
6,772
2,041
36,624

730
941
4
1,675

100,607
249,996
14,058
364,661

4,892
18,414
525
23,831

12,215
24,511
413
37,139

6,913
42,326
3,926
53,165

2,674
20,808
383
23,865

3,682
27,183
1,698
32,563

9,451
15,631
185
25,267

1,151
9,983
558
11,692

3,921
14,029
719
18,669

54,266
66,846
5,599
126,711

1,442
10,265
52
11,759

Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

Family Planning Annual Report: 2014 National Summary

Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

Family Planning Annual Report: 2014 National Summary

Exhibit 14. Distribution of male family planning users, by race, ethnicity, and region: 2014 (Source: FPAR Table 3)
Race and Ethnicity

All Regions

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

0%†
1%
0%†
1%

0%†
0%†
0%
0%†

0%†
0%†
0%†
0%†

0%†
1%
0%†
1%

0%†
0%†
0%†
0%†

0%†
0%†
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%†
2%
0%
2%

Asian
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

0%†
2%
0%†
2%

0%†
2%
0%†
2%

0%†
2%
0%†
2%

0%†
1%
0%†
1%

0%†
2%
0%†
2%

0%†
1%
0%†
1%

0%†
1%
0%†
1%

0%
1%
0%†
1%

0%†
1%
0%†
1%

0%†
4%
0%†
4%

0%†
2%
0%†
2%

2%
18%
0%†
20%

3%
25%
0%†
28%

0%†
47%
1%
48%

0%†
35%
1%
37%

1%
37%
0%†
37%

0%†
29%
1%
30%

0%†
11%
0%†
11%

0%†
11%
1%
12%

0%†
7%
0%†
7%

0%†
0%†
0%
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%
0%†

0%†
0%†
0%†
0%†

0%†
0%†
0%
0%†

0%†
0%†
0%
0%†

0%†
0%†
0%†
0%†

0%†
2%
0%†
2%

0%†
1%
0%
1%

Black or African American
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
White
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
More Than One Race
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
Race Unknown or Not Reported
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal
All Races
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Total All Users

1%
24%
1%
26%
0%†
1%
0%†
1%
12%
34%
1%
48%
2%
1%
0%†
3%

19

Percentage is less than 0.5%.

9%
48%
1%
58%
3%
2%
0%†
5%

7%
30%
0%†
38%
2%
0%†
0%†
2%

1%
43%
3%
47%
0%†
0%†
0%†
0%†
4%
28%
1%
34%
1%
0%†
0%†
2%

13%
5%
1%
19%

6%
7%
1%
13%

21%
8%
1%
29%

6%
6%
3%
15%

28%
69%
4%
100%

21%
77%
2%
100%

33%
66%
1%
100%

13%
80%
7%
100%

Note: Due to rounding, percentages may not sum to 100%.
†

Region I

American Indian or Alaska Native
Hispanic or Latino
Not Hispanic or Latino
Unknown/not reported
Subtotal

7%
36%
1%
43%
2%
1%
0%†
3%
2%
1%
0%†
3%
11%
87%
2%
100%

5%
40%
2%
48%
0%†
1%
0%†
2%
5%
6%
1%
12%
11%
83%
5%
100%

34%
22%
0%†
56%

8%
52%
2%
62%

10%
58%
2%
70%

3%
2%
0%†
6%

5%
66%
0%†
71%

0%†
0%†
0%†
1%

0%†
1%
0%†
1%

2%
1%
0%†
3%

1%
2%
1%
5%

9%
3%
1%
14%

22%
5%
2%
29%

6%
8%
0%†
14%

10%
85%
5%
100%

21%
75%
4%
100%

43%
53%
4%
100%

12%
87%
0%†
100%

37%
62%
1%
100%

1%
1%
0%†
2%

17%
28%
2%
47%

0%†
3%
0%
3%

Guidance for Reporting User Social and Economic Profile Data in FPAR Tables 4 through 6
In FPAR Tables 4, 5, and 6, grantees report information on the social and economic profile of family planning users,
including income level (Table 4), health insurance coverage (Table 5), and English proficiency (Table 6).
In FPAR Table 4, grantees report the unduplicated number of family planning users by income level, using the
following instructions:
Income Level as a Percentage of the HHS Poverty Guidelines—Grantees are required to collect family income
data from all users in order to determine charges based on the schedule of discounts.1,2 In determining a user’s
family income, agencies should refer to the poverty guidelines updated periodically in the Federal Register by HHS
under the authority of 42 USC 9902(2).12 Report the unduplicated number of users by income level, using the most
current income information available. For additional guidance, see Program Requirements for Title X Funded
Family Planning Projects (Version 1.0).1
In FPAR Table 5, grantees report the unduplicated number of users by their principal insurance coverage status,
using the following instructions:
Principal Health Insurance Covering Primary Medical Care—Refers to public and private health insurance
plans that provide a broad set of primary medical care benefits to enrolled individuals. Report the most current
health insurance coverage information available for the client even though he or she may not have used this health
insurance to pay for family planning services received during his or her last encounter. For individuals who have
coverage under more than one health plan, principal insurance is defined as the insurance plan that the agency
would bill first (i.e., primary) if a claim were to be filed. Categories of health insurance covering primary medical
care include public and private sources of coverage.
Public Health Insurance Covering Primary Medical Care—Refers to federal, state, or local government health
insurance programs that provide a broad set of primary medical care benefits for eligible individuals. Examples of
such programs include Medicaid (both regular and managed care), Medicare, the Children’s Health Insurance
Program (CHIP), and other state or local government programs that provide a broad set of benefits (e.g.,
Washington’s Basic Health or Massachusetts’s Commonwealth Care plans). Also included are public-paid or
public-subsidized private insurance programs.
Private Health Insurance Covering Primary Medical Care—Refers to health insurance coverage through an
employer, union, or direct purchase that provides a broad set of primary medical care benefits for the enrolled
individual (beneficiary or dependent). Private insurance includes insurance purchased for public employees or
retirees or military personnel and their dependents (e.g., TRICARE or CHAMPVA).
Uninsured—Refers to clients who do not have a public or private health insurance plan that covers broad, primary
medical care benefits. Clients whose services are subsidized through state or local indigent care programs or
clients insured through the Indian Health Service who obtain care in a nonparticipating facility are considered
uninsured.
In FPAR Table 6, grantees report the unduplicated number of family planning users with limited English proficiency
(LEP), using the following instructions:
Limited English Proficient (LEP) Users—Refers to family planning users who do not speak English as their
primary language and who have a limited ability to read, write, speak, or understand English. Because of their
limited English proficiency, LEP users derive little benefit from Title X services and information provided in English.
In Table 6, report the unduplicated number of family planning users who required language assistance services
(interpretation or translation) to optimize their use of Title X services. Include as LEP any user who received Title X
services from bilingual staff in the user’s preferred non-English language, who was assisted by a competent agency
or contracted interpreter, or who opted to use a family member or friend as an interpreter after refusing the
provider’s offer of free language assistance services. Service providers should consult the Revised HHS LEP
Guidance13 for further information about identifying LEP individuals and complying with language assistance
requirements. Unless they are also LEP, do not include users who are visually or hearing impaired or have other
disabilities.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 21–23.

20

Family Planning Annual Report: 2014 National Summary

FAMILY PLANNING USER SOCIAL AND ECONOMIC PROFILE
Users by Income Level (Exhibit 15)

Federal regulations1,2 require Title X-funded providers to give priority in the delivery of care
to persons from low-income families. These regulations specify that individuals with family
incomes at or below the HHS poverty threshold ($23,850 for a family of four in the 48
contiguous states and DC)8 for the reporting year receive services at no charge unless a third
party (government or private) is authorized or obligated to pay for these services. For
individuals with incomes between 101% and 250% of the poverty threshold (“poverty”), Title
X-funded agencies are required to charge for services using a sliding fee scale based on
family size and income. For unemancipated minors seeking confidential services, the
assessment of income level is based on their own rather than their family’s income.
In 2014, 91% (3.7 million) of users had family incomes that qualified them for either
subsidized or no-charge services. Sixty-nine percent (2.8 million) of users had family incomes
at or below poverty, 22% (907,775) had incomes ranging from 101% to 250% of poverty, and
5% (226,918) had incomes over 250% of poverty. Data on family income were unknown or
not reported for 4% (153,940) of users (Exhibit 15). Additional results include the following:

▪ By region, from 85% (I and VII) to 95% (IX) of users had family incomes qualifying

them for either subsidized (15% to 31%) or no-charge (54% to 75%) services. In three
regions (IV, VI, and IX), the percentage of users with incomes at or below poverty
exceeded the national average of 69% (Exhibit 15).

▪ By state, there was wide variation in the percentage of users with incomes at or below
poverty (36% to 100%), from 101% to 250% of poverty (0% to 60%), and over 250%
of poverty (0% to 22%) (Exhibit B–2).

Since 2004, the percentage of users with family incomes at or below poverty increased
slightly from 68% (2004) to 69% (2014), while the percentage with incomes from 101% to
250% of poverty decreased from 27% in 2005 (the first year disaggregated income data were
available) to 22% in 2014 (Exhibits A–6a and A–6b).
Users by Insurance Coverage Status (Exhibit 16)

Title X regulations1,2 require Title X-funded agencies to bill all third parties authorized or
legally obligated to pay for services and to make reasonable efforts to collect charges without
jeopardizing client confidentiality. On the FPAR, grantees report the health insurance
coverage status for a client even though an insured client may not have used his or her health
insurance to pay for services received during the last encounter. Users whose family planning
care was paid by a Medicaid family planning eligibility expansion but who had no other
public or private health insurance plan covering broad primary medical care benefits are
considered uninsured, as are users with single-service plans (e.g., vision or dental) or those
with coverage through the Indian Health Service (IHS) who received care in non-IHS
facilities.

Family Planning Annual Report: 2014 National Summary

21

Exhibit 15. Number and distribution of all family planning users, by income level and region: 2014 (Source: FPAR Table 4)

22

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

2,840,650

99,958

249,863

304,059

566,646

246,879

223,848

89,042

89,409

865,672

105,274

101% to 150%

572,948

35,296

87,665

58,422

80,800

59,637

35,513

21,703

19,101

146,562

28,249

151% to 200%

234,425

14,375

30,085

27,648

27,881

30,149

13,529

10,406

10,514

59,348

10,490

Income Level a
Under 101%

201% to 250%

100,402

7,367

15,706

13,895

9,906

13,395

6,056

5,606

5,984

17,062

5,425

Over 250%

226,918

11,766

33,370

33,930

50,378

21,777

9,780

8,531

12,079

37,918

7,389

Unknown/not reported

153,940

15,243

12,720

30,203

34,890

5,715

9,568

13,117

422

23,219

8,843

4,129,283

184,005

429,409

468,157

770,501

377,552

298,294

148,405

137,509

1,149,781

165,670

Under 101%

69%

54%

58%

65%

74%

65%

75%

60%

65%

75%

64%

101% to 150%

14%

19%

20%

12%

10%

16%

12%

15%

14%

13%

17%

151% to 200%

6%

8%

7%

6%

4%

8%

5%

7%

8%

5%

6%

201% to 250%

2%

4%

4%

3%

1%

4%

2%

4%

4%

1%

3%

Over 250%

5%

6%

8%

7%

7%

6%

3%

6%

9%

3%

4%

Unknown/not reported

4%

8%

3%

6%

5%

2%

3%

9%

0%†

2%

5%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Total All Users

Family Planning Annual Report: 2014 National Summary

Total All Users

100%

Note: Due to rounding, percentages may not sum to 100%.
a

Title X-funded agencies calculate and report user family income as a percentage of poverty based on guidelines issued by the U.S. Department of Health and Human Services
(HHS). Each year, HHS announces updates to its poverty guidelines in the Federal Register and on the HHS Website at http://aspe.hhs.gov/poverty/.

†

Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

Exhibit 16. Number and distribution of all family planning users, by principal health insurance coverage status and region: 2014
(Source: FPAR Table 5)
Insurance Status
Public health insurance

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

1,215,648

78,738

177,734

150,611

258,856

123,846

63,773

28,091

20,353

262,168

51,478

Private health insurance

559,845

53,951

55,230

96,198

95,376

62,457

50,176

36,388

31,056

43,109

35,904

2,239,377

49,979

179,494

204,673

373,918

188,557

183,404

82,650

78,777

822,120

75,805

114,413

1,337

16,951

16,675

42,351

2,692

941

1,276

7,323

22,384

2,483

4,129,283

184,005

429,409

468,157

770,501

377,552

298,294

148,405

137,509

1,149,781

165,670

Public health insurance

29%

43%

41%

32%

34%

33%

21%

19%

15%

23%

31%

Private health insurance

14%

29%

13%

21%

12%

17%

17%

25%

23%

4%

22%

Uninsured

54%

27%

42%

44%

49%

50%

61%

56%

57%

72%

46%

3%

1%

4%

4%

5%

1%

1%

5%

2%

1%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Uninsured
Unknown/not reported
Total All Users

Unknown/not reported
Total All Users

Note: Due to rounding, percentages may not sum to 100%.
†

Percentage is less than 0.5%.

0%†
100%

23

In 2014, 54% (2.2 million) of family planning users were uninsured and 43% (1.8 million)
had either public (29%, 1.2 million) or private (14%, 559,845) insurance covering broad
primary medical care benefits. Health insurance coverage status was unknown or not reported
for 3% (114,413) of users (Exhibit 16). Additional results include the following:

▪ By region, the percentage of uninsured users ranged from 27% (I) to 72% (IX). From

15% (VIII) to 43% (I) of users had public coverage, and 4% (IX) to 29% (I) had private
coverage. In all but four regions (I, II, III, and X), the percentage of uninsured users
exceeded the percentage insured (Exhibit 16).

▪ By state, there was wide variation in the percentage of users with private health

insurance (0% to 53%), Medicaid or other public health insurance (0% to 98%), and no
health insurance (less than 1% to 100%) (Exhibit B–3).

In 2014, the percentage of users with public or private health insurance (43%) was 14 points
higher than in 2005 (29%) (the first year data were available), while the percentage uninsured
was 7 points lower (54% in 2014 vs. 61% in 2005). Several factors account for these
insurance coverage trends, including better collection of health insurance data (i.e., fewer
users with an unknown health insurance status), increased administrative efforts to identify
and bill third-party payers, and state and national (i.e., Affordable Care Act [ACA]) reforms
aimed at increasing insurance coverage (Exhibits A–7a and A–7b).
Limited English Proficient Users (Exhibit 17)

As recipients of HHS assistance, Title X grantees and subrecipients, including those operating
in U.S. territories and Freely Associated States where English is an official language, are
required to ensure that limited English proficient (LEP) individuals have meaningful access to
the health and social services they provide.13 The 2014 results for LEP status are the
following (Exhibit 17):

▪ 13% (522,944) of total family planning users were LEP, including 12% (499,421) of
users in the 50 states and the District of Columbia (not shown).

▪ By region, the percentage of users who were LEP ranged from 7% (V) to 18% (VI),
with three regions (II, VI, and IX) exceeding the national average of 13%.

Since 2005 (the first year these data were available), the percentage of total users who are
LEP increased by 1 point, from 12% in 2005 to 13% in 2014. Numerically, however, the
number of LEP users decreased 13%, from 602,524 (2005) to 522,944 (2014) (not shown).

24

Family Planning Annual Report: 2014 National Summary

Family Planning Annual Report: 2014 National Summary

Exhibit 17. Number and distribution of all family planning users, by limited English proficiency (LEP) status and region: 2014
(Source: FPAR Table 6)
LEP Status

All Regions

Region I

Region II a

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX b

Region X

522,944

20,452

70,963

45,937

94,489

25,801

54,028

12,611

13,730

169,075

15,858

3,517,740

163,539

357,457

383,958

667,104

351,751

223,804

135,063

123,748

977,657

133,659

88,599

14

989

38,262

8,908

0

20,462

731

31

3,049

16,153

4,129,283

184,005

429,409

468,157

770,501

377,552

298,294

148,405

137,509

1,149,781

165,670

LEP

13%

11%

17%

10%

12%

7%

18%

8%

10%

15%

10%

Not LEP

85%

89%

83%

82%

87%

93%

75%

91%

90%

85%

8%

1%

0%

7%

100%

100%

100%

100%

LEP
Not LEP
Unknown/not reported
Total All Users

Unknown/not reported
Total All Users

2%
100%

0%†
100%

0%†
100%

0%†
100%

0%†
100%

LEP=limited English proficient.
Note: Due to rounding, percentages may not sum to 100%.
a

Puerto Rico and the U.S. Virgin Islands.

b

American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Republic of the Marshall Islands, Republic of Palau.

†

Percentage is less than 0.5%.

0%†
100%

81%
10%
100%

25

Guidance for Reporting Primary Contraceptive Use Data in FPAR Tables 7 and 8
In FPAR Table 7, grantees report the unduplicated number of female family planning users by primary method and
age, and in FPAR Table 8, grantees report the unduplicated number of male family planning users by primary
method and age. The FPAR instructions provide the following guidance for reporting this information:
Age—Use the client’s age as of June 30 of the reporting period.
Primary Method of Family Planning—The primary method of family planning is the user’s method—adopted or
continued—at the time of exit from his or her last encounter in the reporting period. If the user reports that he or she
is using more than one family planning method, report the most effective one as the primary method. Family planning
methods include the following:
Female Sterilization—In Table 7, report the number of female users who rely on female sterilization as their
primary family planning method. Female sterilization refers to a contraceptive surgical (tubal ligation) or nonsurgical
(implant) procedure performed on a female user in the current or any previous reporting period.
Intrauterine Device or System (IUD/IUS)—In Table 7, report the number of female users who use a long-term
hormonal or other type of intrauterine device (IUD) or system (IUS) as their primary family planning method.
Hormonal Implant—In Table 7, report the number of female users who use a long-term, subdermal hormonal
implant as their primary family planning method.
1-Month Hormonal Injection—In Table 7, report the number of female users who use 1-month injectable
hormonal contraception as their primary family planning method.
3-Month Hormonal Injection—In Table 7, report the number of female users who use 3-month injectable
hormonal contraception as their primary family planning method.
Oral Contraceptive—In Table 7, report the number of female users who use any oral contraceptive, including
combination and progestin-only (“mini-pills”) formulations, as their primary family planning method.
Contraceptive Patch—In Table 7, report the number of female users who use a transdermal contraceptive patch
as their primary family planning method.
Vaginal Ring—In Table 7, report the number of female users who use a hormonal vaginal ring as their primary
family planning method.
Cervical Cap or Diaphragm—In Table 7, report the number of female users who use a cervical cap or diaphragm
(with or without spermicidal jelly or cream) as their primary family planning method.
Contraceptive Sponge—In Table 7, report the number of female users who use a contraceptive sponge as their
primary family planning method.
Female Condom—In Table 7, report the number of female users who use female condoms (with or without
spermicidal foam or film) as their primary family planning method.
Spermicide (used alone)—In Table 7, report the number of female users who use only spermicidal jelly, cream,
foam, or film (i.e., not in conjunction with another method of contraception) as their primary family planning method.
Fertility Awareness Method (FAM) or Lactational Amenorrhea Method (LAM)—Fertility awareness methods
(FAMs) refer to family planning methods that rely on identifying the fertile days in each menstrual cycle when
intercourse is most likely to result in a pregnancy. FAMs include Standard Days®, Calendar Rhythm, TwoDay,
Billings Ovulation, and SymptoThermal methods. The Lactational Amenorrhea Method (LAM) is the proactive
application of exclusive breastfeeding during lactational amenorrhea for the first 6 months after delivery. To be
effective, LAM requires full (i.e., no other liquid or solid given to infant) or nearly full (i.e., infrequent
supplementation in small amounts, but not by bottle) breastfeeding.14 In Table 7, report the number of female
users who use one or a combination of the FAMs listed above or who rely on LAM as their primary family planning
method. In Table 8, Row 3 report male users who rely on a FAM as their primary method. Report male users who
rely on LAM as their primary method in Table 8, Row 6, “Rely on female method(s).”
Abstinence—In Tables 7 and 8, report the number of female and male users, respectively, who rely on abstinence
as their primary family planning method or who are not currently sexually active and therefore not using
contraception. For purposes of FPAR reporting, abstinence is defined as refraining from oral, vaginal, and anal
intercourse.14
Withdrawal and Other Methods—In Tables 7 and 8, report the number of female and male users, respectively,
who use withdrawal or other methods not listed in the tables as their primary family planning method.
(continued)

26

Family Planning Annual Report: 2014 National Summary

PRIMARY CONTRACEPTIVE METHOD USE
Federal regulations1,2 specify that Title X projects are required to provide a broad range of
acceptable and effective medically approved family planning methods, including natural
family planning methods. In addition to offering a full range of methods for clients to
consider, the Quality Family Planning (QFP) Recommendations15 advise providers to identify
methods that are safe for the client, provide counseling to help the client choose a method and
use it correctly and consistently, conduct any physical assessments warranted by the selected
method, and provide the method on site (preferable) or by referral. The QFP
Recommendations also note that providers should ensure that services for adolescent clients
are provided in a “youth-friendly” way.
Female Users by Primary Contraceptive Method (Exhibits 18 through
21)

In 2014, 84% (3.2 million) of all female users adopted or continued use of a contraceptive
method at exit from their last encounter in the reporting period. Nine percent (330,279) of
females exited the encounter with no primary method because they were pregnant or seeking
pregnancy; 5% (175,111) exited with no method for other reasons. The type of primary
method used was unknown or not reported for 3% (98,207) of female users (Exhibits 18
and 19).

Guidance for Reporting Primary Contraceptive Use Data in FPAR Tables 7 and 8 (continued)
Vasectomy—Refers to conventional incisional or no-scalpel vasectomy performed on a male user, or the male
partner of a female user, in the current or any previous reporting period. In Table 7, report the number of female
users who rely on vasectomy as their (partner’s) primary family planning method. In Table 8, report the number of
male users on whom a vasectomy was performed in the current or any previous reporting period.
Male condom—In Table 7, report the number of female users who rely on their sexual partner to use male
condoms (with or without spermicidal foam or film) as their primary family planning method. In Table 8, report the
number of male users who use male condoms (with or without spermicidal foam or film) as their primary family
planning method.
No Method–[Partner] Pregnant or Seeking Pregnancy—In Tables 7 and 8, report the number of female and
male, respectively, users who are not using any family planning method because they (Table 7) or their partners
(Table 8) are pregnant or seeking pregnancy.
No Method–Other Reason—In Tables 7 and 8, report the number of female and male users who are not using any
family planning method to avoid pregnancy due to reasons other than pregnancy or seeking pregnancy, including if
either partner is sterile without having been sterilized surgically, if either partner has had a noncontraceptive surgical
procedure that has rendered him or her unable to conceive or impregnate, or if the user has a sexual partner of the
same sex.
Method Unknown or Not Reported—In Tables 7 and 8, report the number of female and male users, respectively,
for whom the primary family planning method at exit from the last family planning encounter is unknown or not
reported.
Rely on Female Method(s)—In Table 8, report the number of male family planning users who rely on their female
partner’s family planning methods as their primary method. “Female” contraceptive methods include female
sterilization, IUD/IUS, hormonal implants, 1- and 3-month hormonal injections, oral contraceptives, the contraceptive
patch, the vaginal ring, cervical cap or diaphragms, the contraceptive sponge, female condoms, LAM, and
spermicides.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 27–30.

Family Planning Annual Report: 2014 National Summary

27

Additional results include the following:

▪ By level of effectiveness in preventing pregnancy,10 13% of female users relied on a

highly effective contraceptive method (vasectomy, female sterilization, implant, or
IUD), 51% used a moderately effective method (injectable contraception, vaginal ring,
patch, pills, diaphragm, or cervical cap), and 18% used a less effective method (male
condom, female condom, sponge, withdrawal, a fertility awareness-based method
[FAM], or spermicide used alone) (Exhibits 18 and 19).

▪ By type of method, the leading method was pills, which were used by 30% of female
users (Exhibits 18 and 19).

– Injectable contraception was the second most common method (16% of female
users), followed by male condoms (15%), IUDs (7%), hormonal implants (4%), the
vaginal ring (3%), female sterilization (2%), and the contraceptive patch (2%).
– Less than 1% of female users relied on each of the following methods: a FAM or the
lactational amenorrhea method (LAM), vasectomy, female condoms, spermicide
(used alone), cervical cap or diaphragm, or the sponge.
– 2% of female users reported using withdrawal or other methods not listed in FPAR
Table 7, and 2% reported that they were abstinent.

▪ By age group, from 5% (under 15) to 20% (over 39) of female users relied on highly
effective methods, 28% (over 44) to 64% (15 to 17) relied on moderately effective
methods, and 10% (under 15) to 28% (over 44) relied on less effective methods
(Exhibits 18 and 19).

– Females 15 to 44 preferred pills (22% to 36%) followed by either injectables (14% to
25%) or male condoms (13% to 20%).
– Females under 15 preferred pills (25%), injectables (24%), and male condoms (9%);
20% were abstinent.
– Females over 44 preferred male condoms (21%), pills (16%), and female sterilization
(13%).
– Nonuse of contraception because of pregnancy or the desire for pregnancy was
highest among females 18 to 39 (8% to 11%) and 5% or less among females in the
younger (under 18) and older (over 39) age groups.

▪ By region, from 78% (VI) to 89% (IX and X) of female users exited the encounter with
a primary method (Exhibits 20 and 21).

– The percentage of female users relying on highly effective methods ranged from 10%
(III and IV) to 18% (I), while 41% (I) to 60% (VIII and X) used moderately effective
methods.
– Pills, used by 26% (I) to 37% (VIII) of females, were the leading method in all
regions. The second and third most common methods were injectables and condoms
in six regions (III, IV, V, VI, and VII), condoms and injectables in three regions (I,
II, and IX), and injectables and IUDs in two regions (VIII and X).
– Nonuse of contraception because of pregnancy or the desire for pregnancy ranged
from 6% (III) to 11% (II and IV).
28

Family Planning Annual Report: 2014 National Summary

▪ By state, there was wide variation in the percentage of female users at risk of

unintended pregnancy who relied on highly effective (2% to 37%), moderately effective
(35% to 86%), and less effective (1% to 41%) contraceptive methods (Exhibit B–4).

Trends in Female Primary Contraceptive Method Use

▪ Any method: From 2004 to 2014, the percentage of all female users relying on any

method, including abstinence, ranged from 81% to 85%. Thirteen percent to 15% used
no method either because they were pregnant, seeking pregnancy, or for other reasons
(Exhibit A–8a).

▪ Highly effective method use: Among female method users (excludes those who were

pregnant, seeking pregnancy, not using a method for other reasons, or whose primary
method was unknown), the percentage relying on highly effective methods increased
from 5% in 2004 to 15% in 2014. Numerically, the number of highly effective method
users more than doubled, from 188,478 (2004) to 487,640 (2014), with IUD and
implant use accounting for this increase (Exhibits A–8a, A–8b, and A–8c).

– IUD use increased from 2% of female method users in 2004 to 8% in 2014.
Numerically, the number of IUD users grew 241%, from 77,773 in 2004 to 265,511
in 2014.
– Implant use increased from less than 1% of female method users in 2004 to 4% in
2014. The large increase (2,396%) in the number of females using implants (5,602 in
2004 vs. 139,799 in 2014) was made possible by the availability of a newer hormonal
implant introduced in late 2006.

▪ Moderately effective method use: The percentage of female method users relying on

moderately effective methods decreased from 68% in 2004 to 61% in 2014.
Numerically, the number of moderately effective method users declined 29%, from 2.7
million (2004) to 1.9 million (2014) (Exhibits A–8a, A–8b, and A–8c).
– Pills were the leading method for female users in all years, accounting for 49% of
method use in 2004 and 36% in 2014.

– Injectable contraception, the second most commonly used moderately effective
method, was preferred by 18% of female method users in 2004 and 19% in 2014.
– The vaginal ring and hormonal patch were ranked either third or fourth most
common moderately effective methods used since 2005, when the FPAR began
collecting data for these two methods. The percentage of female method users
relying on the vaginal ring increased from 2% in 2005 to 4% in 2014, while the
percentage using the hormonal patch decreased from 7% in 2005 to 2% in 2014.
– Less than 1% of female users relied on either the cervical cap or diaphragm in 2004
and 2014.

▪ Less-effective method use: The percentage of female method users relying on less-

effective methods decreased from 27% in 2004 to 21% in 2014. Among females relying
on less-effective methods, male condoms were preferred by 67% in 2004 and 86% in
2014 (Exhibits A–8b and A–8c).

Family Planning Annual Report: 2014 National Summary

29

Exhibit 18. Number of female family planning users, by primary contraceptive method and age: 2014 (Source: FPAR Table 7)

30
Primary Method

All Age
Groups

Female sterilization

74,748

Intrauterine device

265,511

Hormonal implant

139,799

Hormonal injection

611,619a

Under 15
Years

15 to 17
Years

18 to 19
Years

20 to 24
Years

25 to 29
Years

30 to 34
Years

35 to 39
Years

40 to 44
Years

Over 44
Years

0

3

1,262

7,084

13,859

16,281

15,667

227

5,334

12,381

63,325

71,994

53,606

32,311

17,529

8,804

1,641

15,882

18,796

49,610

29,712

13,900

6,420

2,750

1,088

8,847

68,726a

74,078a

169,234a

119,443a

81,225a

46,286a

26,901a

16,879a

1,135,950

9,121

95,517

134,948

359,467

256,535

140,452

72,927

40,587

26,396

69,469

752

6,072

7,845

21,409

15,956

10,047

4,788

1,945

655

115,230

228

4,795

9,424

39,985

35,425

16,834

5,511

2,090

938

2,379

7

69

105

433

533

474

311

207

240

651

7

50

67

157

139

106

47

36

42

Female condom

3,308

40

257

305

796

609

423

310

257

311

Spermicide (used alone)

2,911

12

184

215

814

547

402

333

209

195
1,130

Oral contraceptive
Contraceptive patch
Vaginal ring
Cervical cap or diaphragm
Contraceptive sponge

0

20,592

Family Planning Annual Report: 2014 National Summary

FAM or LAM b

12,648

41

434

833

2,600

2,801

2,208

1,504

1,097

Abstinence c

70,098

7,379

9,048

5,228

12,319

10,260

7,472

5,620

4,656

8,116

Withdrawal or other method d

70,982

354

3,497

5,259

17,532

14,774

9,910

6,466

4,767

8,423

Rely on Male Method
Vasectomy
Male condom

7,582

0

5

23

369

931

1,541

1,620

1,550

1,543

578,139

3,321

34,364

54,201

161,380

121,819

80,595

52,260

35,754

34,445

No Method
Pregnant/seeking pregnancy

330,279

734

13,021

30,252

106,086

88,527

54,439

26,291

8,654

2,275

Other reason

175,111

1,953

10,727

14,061

42,784

35,591

24,145

15,428

11,320

19,102

Method Unknown e

98,208

1,962

6,538

7,949

21,901

19,426

14,037

9,760

7,244

9,391

Total Female Users

3,764,622

36,626

274,520

375,973

1,071,463

832,106

525,675

304,474

183,220

160,565

Using a Method

3,161,024

31,977

244,234

323,711

900,692

688,562

433,054

252,995

156,002

129,797

Not Using a Method

505,390

2,687

23,748

44,313

148,870

124,118

78,584

41,719

19,974

21,377

Method Unknown e

98,208

1,962

6,538

7,949

21,901

19,426

14,037

9,760

7,244

9,391

FAM=fertility awareness-based method. LAM=lactational amenorrhea method.
a
b
c
d
e

Includes both 3-month and 1-month hormonal injection users. See Table 7 comments in the Field and Methodological Notes (Appendix C).
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
User refrained from oral, vaginal, and anal intercourse.
Includes withdrawal or any other method not listed in FPAR Table 7.
See Table 7 comments in the Field and Methodological Notes (Appendix C).

Family Planning Annual Report: 2014 National Summary

Exhibit 19. Distribution of female family planning users, by primary contraceptive method and age: 2014 (Source: FPAR Table 7)
All Age
Groups

Under 15
Years

15 to 17
Years

25 to 29
Years

30 to 34
Years

35 to 39
Years

40 to 44
Years

Over 44
Years

Female sterilization

2%

0%

0%

0%†

0%†

1%

3%

5%

9%

13%

Intrauterine device

7%

1%

2%

Hormonal implant

4%

4%

6%

3%

6%

9%

10%

11%

10%

5%

5%

5%

4%

3%

2%

2%

1%

Hormonal injection

16%a

24%

25%a

20%a

16%a

14%a

15%a

15%a

15%a

11%a

Oral contraceptive

30%

25%

35%

36%

34%

31%

27%

24%

22%

16%

Contraceptive patch
Vaginal ring

2%

2%

2%

2%

2%

2%

2%

2%

1%

0%†

3%

1%

2%

3%

4%

4%

3%

2%

1%

1%

Cervical cap or diaphragm

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Contraceptive sponge

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Female condom

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Spermicide (used alone)

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

FAM or LAM b

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

1%

1%

Primary Method

Abstinence c
Withdrawal or other method

d

18 to 19
Years

20 to 24
Years

2%

20%

3%

1%

1%

1%

1%

2%

3%

5%

2%

1%

1%

1%

2%

2%

2%

2%

3%

5%

0%†

0%

0%†

0%†

0%†

0%†

0%†

1%

1%

1%

Rely on Male Method
Vasectomy
Male condom

15%

9%

13%

14%

15%

15%

15%

17%

20%

21%

Pregnant/seeking pregnancy

9%

2%

5%

8%

10%

11%

10%

9%

5%

1%

Other reason

12%

No Method
5%

5%

4%

4%

4%

4%

5%

5%

6%

Method Unknown e

3%

5%

2%

2%

2%

2%

3%

3%

4%

6%

Total Female Users

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Using a Method

84%

87%

89%

86%

84%

83%

82%

83%

85%

81%

Not Using a Method

13%

7%

9%

12%

14%

15%

15%

14%

11%

13%

Method Unknown e

3%

5%

2%

2%

2%

2%

3%

3%

4%

6%

FAM=fertility awareness-based method. LAM=lactational amenorrhea method.
Note: Due to rounding, percentages may not sum to 100%.
a
b
c
d

31

e

†

Includes both 3-month and 1-month hormonal injection users. See Table 7 comments in the Field and Methodological Notes (Appendix C).
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
User refrained from oral, vaginal, and anal intercourse.
Includes withdrawal or any other method not listed in FPAR Table 7.
See Table 7 comments in the Field and Methodological Notes (Appendix C).
Percentage is less than 0.5%.

Exhibit 20. Number of female family planning users, by primary contraceptive method and region: 2014 (Source: FPAR Table 7)

32

Primary Method

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Female sterilization

74,748

6,469

8,943

9,736

9,987

6,596

6,055

5,896

1,989

16,385

2,692

Intrauterine device

265,511

15,218

34,266

20,842

36,626

20,309

15,966

7,842

10,627

88,255

15,560

Hormonal implant

139,799

7,234

10,128

10,100

25,395

11,339

10,826

5,126

6,178

46,241

7,232

Hormonal injection

611,619a

16,729a

45,469

74,449a

182,250a

65,575a

50,796a

27,071

19,463a

105,824a

23,993

1,135,950

41,538

108,705

120,397

223,421

112,606

72,423

45,684

44,127

311,433

55,616

69,469

2,513

8,803

6,649

8,905

6,613

6,058

1,971

1,832

21,340

4,785

115,230

4,394

12,326

12,764

13,097

12,300

4,455

3,378

6,153

38,410

7,953

2,379

71

241

613

337

302

36

53

66

536

124

651

22

23

78

160

21

86

20

13

210

18

3,308

81

800

977

194

212

200

19

51

732

42

Oral contraceptive
Contraceptive patch
Vaginal ring
Cervical cap or diaphragm
Contraceptive sponge
Female condom
Spermicide (used alone)
FAM or LAM b

2,911

43

76

349

1,324

82

630

25

36

266

80

12,648

495

1,429

811

3,199

365

1,969

460

226

3,446

248

Family Planning Annual Report: 2014 National Summary

Abstinence c

70,098

7,549

5,811

8,280

10,664

5,272

5,427

2,274

2,155

19,803

2,863

Withdrawal or other method d

70,982

2,337

13,356

5,056

17,362

4,232

3,088

1,955

716

21,305

1,575

Rely on Male Method
Vasectomy

7,582

661

494

541

1,176

437

252

530

511

2,479

501

578,139

28,017

72,540

61,670

73,227

40,085

34,636

12,898

9,709

231,312

14,045

Pregnant/seeking pregnancy

330,279

10,834

44,252

26,254

83,309

28,439

21,775

13,209

8,592

82,099

11,516

Other reason

4,729

Male condom
No Method

175,111

11,210

22,617

26,127

31,567

22,228

21,924

5,126

5,418

24,165

Method Unknown e

98,208

4,759

1,991

29,299

24,436

7,976

16,425

3,176

978

8,829

339

Total Female Users

3,764,622

160,174

392,270

414,992

746,636

344,989

273,027

136,713

118,840

1,023,070

153,911

Using a Method

333,312

607,324

286,346

212,903

115,202

103,852

907,977

137,327

3,161,024

133,371

323,410

Not Using a Method

505,390

22,044

66,869

52,381

114,876

50,667

43,699

18,335

14,010

106,264

16,245

Method Unknown e

98,208

4,759

1,991

29,299

24,436

7,976

16,425

3,176

978

8,829

339

FAM=fertility awareness-based method. LAM=lactational amenorrhea method.
a
b
c
d
e

Includes both 3-month and 1-month hormonal injection users. See Table 7 comments in the Field and Methodological Notes (Appendix C).
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
User refrained from oral, vaginal, and anal intercourse.
Includes withdrawal or any other method not listed in FPAR Table 7.
See Table 7 comments in the Field and Methodological Notes (Appendix C).

Family Planning Annual Report: 2014 National Summary

Exhibit 21. Distribution of female family planning users, by primary contraceptive method and region: 2014 (Source: FPAR Table 7)
Primary Method

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Female sterilization

2%

4%

2%

2%

1%

2%

2%

4%

2%

2%

2%

Intrauterine device

7%

10%

9%

5%

5%

6%

6%

6%

9%

9%

10%

Hormonal implant

4%

5%

3%

2%

3%

3%

4%

4%

5%

5%

5%

Hormonal injection

16%a

10%a

12%

18%a

24%a

19%a

19%a

20%

16%a

10%a

16%

Oral contraceptive

30%

26%

28%

29%

30%

33%

27%

33%

37%

30%

36%

Contraceptive patch

2%

2%

2%

2%

1%

2%

2%

1%

2%

2%

3%

Vaginal ring

3%

3%

3%

3%

2%

4%

2%

2%

5%

4%

5%

Cervical cap or diaphragm

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Contraceptive sponge

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Female condom

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Spermicide (used alone)

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

FAM or LAM b

0%†

0%†

0%†

0%†

0%†

0%†

1%

0%†

0%†

0%†

0%†

Abstinence c

2%

5%

1%

2%

1%

2%

2%

2%

2%

2%

2%

Withdrawal or other method d

2%

1%

3%

1%

2%

1%

1%

1%

1%

2%

1%

Rely on Male Method
Vasectomy
Male condom

0%†

0%†

15%

0%†

17%

0%†

18%

0%†

15%

0%†

10%

0%†

12%

0%†

13%

0%†

9%

8%

23%

0%†

9%

0%†

9%

7%

11%

6%

11%

8%

8%

10%

7%

8%

7%

No Method
Pregnant/seeking pregnancy
Other reason

5%

7%

6%

6%

4%

6%

8%

4%

5%

2%

3%

Method Unknown e

3%

3%

1%

7%

3%

2%

6%

2%

1%

1%

0%†

Total Female Users

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Using a Method

84%

83%

82%

80%

81%

83%

78%

84%

87%

89%

89%

Not Using a Method

13%

14%

17%

13%

15%

15%

16%

13%

12%

10%

11%

Method Unknown e

3%

3%

1%

7%

3%

2%

6%

2%

1%

1%

FAM=fertility awareness-based method. LAM=lactational amenorrhea method.
Note: Due to rounding, percentages may not sum to 100%.
a
b
c
d

33

e

†

Includes both 3-month and 1-month hormonal injection users. See Table 7 comments in the Field and Methodological Notes (Appendix C).
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
User refrained from oral, vaginal, and anal intercourse.
Includes withdrawal or any other method not listed in FPAR Table 7.
See Table 7 comments in the Field and Methodological Notes (Appendix C).
Percentage is less than 0.5%.

0%†

This page intentionally left blank.

34

Family Planning Annual Report: 2014 National Summary

Male Users by Primary Contraceptive Method (Exhibits 22 through 25)

In 2014, grantees reported that 88% (319,279) of all male users had adopted or continued use
of a primary contraceptive method at exit from their last encounter in the reporting period.
Seven percent (24,754) of males used no primary method, either because their partners were
pregnant or seeking pregnancy (1%) or for other reasons (6%). The type of primary
contraceptive method used was unknown or not reported for 6% (20,628) of male users
(Exhibits 22 and 23). Additional results include the following:

▪ By type of method, male condoms were used by a majority (72%) of male users,

followed by reliance on a female method (6%), abstinence (6%), withdrawal or other
method (3%), vasectomy (1%), or a FAM (less than 1%) (Exhibits 22 and 23).

▪ By age group, from 80% (over 44) to 90% (18 to 24) of male users exited the encounter
with a primary contraceptive method (Exhibits 22 and 23).

– Males 18 or over preferred male condoms (55% to 80%) followed by reliance on a
female method (5% to 10%).
– Among males under 18, those 15 to 17 preferred condoms (59%) followed by
abstinence (20%), while males under 15 preferred abstinence (60%) followed by
male condoms (18%).
– For males 20 or over, vasectomy prevalence ranged from less than 1% to 3%.
– Between 2% and 5% of male users in each age group relied on withdrawal or other
methods not listed in FPAR Table 8, and less than 1% relied on a FAM.
– Nonuse of contraception because a partner was pregnant or seeking pregnancy was
reported for 1% or less of male users in all age groups.

▪ By region, the percentage of males who used any method ranged from 72% (III) to 95%
(IX) (Exhibits 24 and 25).

– Male condoms, used by 52% (X) to 83% (IX) of male users, were the leading method
in all regions.
– Reliance on a female method (5% to 20% of males) was the second most common
method in six regions (II, IV, V, VII, VIII, and IX), while abstinence (5% to 26%)
was the second most common method in four others (I, III, VI, and X).
– Methods with less than 5% of male users included withdrawal (1% to 4%),
vasectomy (<1% to 3%), and FAMs (<1% to 2%).
– The percentage of male users who exited the encounter with no method because of
“other reasons” ranged from 3% (IX) to 10% (IV and VIII).
– Nonuse of contraception because a partner was pregnant or seeking pregnancy was
reported for 2% or less of male users in all regions, while nonuse for “other reasons”
ranged from 3% (IX) to 10% (IV and VIII).

Family Planning Annual Report: 2014 National Summary

35

Exhibit 22. Number of male family planning users, by primary contraceptive method and age: 2014 (Source: FPAR Table 8)

36

All Age
Groups

Primary Method
Vasectomy
Male condom
FAM a
Abstinence

b

Withdrawal or other method

c

Rely on female method d

Under 15
Years

15 to 17
Years

18 to 19
Years

20 to 24
Years

25 to 29
Years

30 to 34
Years

35 to 39
Years

40 to 44
Years

Over 44
Years

2,763

0

0

0

71

346

590

652

491

613

262,255

1,706

14,337

22,050

79,022

62,528

34,989

18,574

11,338

17,711

1,079

6

29

56

250

251

162

115

70

140

21,127

5,512

4,974

1,246

1,977

1,761

1,324

919

816

2,598

9,992

149

675

633

2,093

1,884

1,352

882

700

1,624

22,063

167

761

1,298

5,022

4,715

3,199

2,145

1,645

3,111

3,253

36

165

168

751

708

556

344

210

315

21,501

771

1,696

1,415

4,876

4,352

2,695

1,659

1,213

2,824

No Method
Partner pregnant/seeking pregnancy
Other reason
Method Unknown

e

Family Planning Annual Report: 2014 National Summary

20,628

890

1,682

1,358

4,423

3,479

2,468

1,675

1,252

3,401

Total Male Users

364,661

9,237

24,319

28,224

98,485

80,024

47,335

26,965

17,735

32,337

Using a Method

319,279

7,540

20,776

25,283

88,435

71,485

41,616

23,287

15,060

25,797

Not Using a Method

24,754

807

1,861

1,583

5,627

5,060

3,251

2,003

1,423

3,139

Method Unknown

20,628

890

1,682

1,358

4,423

3,479

2,468

1,675

1,252

3,401

e

FAM=fertility awareness-based method.
a
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
b
User refrained from oral, vaginal, and anal intercourse.
c
Includes withdrawal or any other method not listed in FPAR Table 8.
d
Primary method of user’s sex partner was female sterilization, intrauterine device, hormonal implant, hormonal injection, oral contraceptive, contraceptive patch, vaginal ring,
female barrier method (cervical cap, diaphragm, sponge, female condom), spermicide, or the lactational amenorrhea method.
e
See Table 8 comments in the Field and Methodological Notes (Appendix C).

Family Planning Annual Report: 2014 National Summary

Exhibit 23. Distribution of male family planning users, by primary contraceptive method and age: 2014 (Source: FPAR Table 8)
All Age
Groups

Primary Method
Vasectomy
Male condom
FAM a
Abstinence

Under 15
Years

15 to 17
Years

18 to 19
Years

1%

0%

0%

0%

72%

18%

59%

78%

0%†

0%†

0%†

20 to 24
Years
0%†
80%

25 to 29
Years
0%†
78%

30 to 34
Years

35 to 39
Years

40 to 44
Years

Over 44
Years

1%

2%

3%

2%

74%

69%

64%

55%

0%†

0%†

0%†

0%†

0%†

0%†

0%†
8%

6%

60%

20%

4%

2%

2%

3%

3%

5%

3%

2%

3%

2%

2%

2%

3%

3%

4%

5%

6%

2%

3%

5%

5%

6%

7%

8%

9%

10%

Partner pregnant/seeking pregnancy

1%

0%†

1%

1%

1%

1%

1%

1%

1%

1%

Other reason

6%

8%

7%

5%

5%

5%

6%

6%

7%

9%

b

Withdrawal or other method

c

Rely on female method d
No Method

Method Unknown

e

6%

10%

7%

5%

4%

4%

5%

6%

7%

11%

Total Male Users

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Using a Method

88%

82%

85%

90%

90%

89%

88%

86%

85%

80%

Not Using a Method

7%

9%

8%

6%

6%

6%

7%

7%

8%

10%

Method Unknown

6%

10%

7%

5%

4%

4%

5%

6%

7%

11%

e

FAM=fertility awareness-based method.
Note: Due to rounding, percentages may not sum to 100%.
a
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
b
User refrained from oral, vaginal, and anal intercourse.
c
Includes withdrawal or any other method not listed in FPAR Table 8.
d
Primary method of user’s sex partner was female sterilization, intrauterine device, hormonal implant, hormonal injection, oral contraceptive, contraceptive patch, vaginal ring,
female barrier method (cervical cap, diaphragm, sponge, female condom), spermicide, or the lactational amenorrhea method.
e
See Table 8 comments in the Field and Methodological Notes (Appendix C).
† Percentage is less than 0.5%.

37

Exhibit 24. Number of male family planning users, by primary contraceptive method and region: 2014 (Source: FPAR Table 8)

38

All
Regions

Primary Method
Vasectomy
Male condom
FAM a
Abstinence

b

Withdrawal or other method

c

Rely on female method d

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII Region VIII Region IX

Region X

2,763

133

86

117

613

158

191

81

391

778

215

262,255

14,514

29,213

31,554

13,419

24,258

18,280

8,661

11,222

104,974

6,160

1,079

42

29

104

240

5

458

25

13

155

8

21,127

3,663

924

2,693

2,409

1,062

1,703

309

955

4,320

3,089

9,992

543

1,450

1,941

543

284

744

241

110

3,621

515

22,063

1,761

2,304

1,880

2,423

1,514

542

1,234

3,744

5,997

664

3,253

404

161

132

108

102

185

131

265

1,672

93

21,501

2,017

2,630

3,269

2,289

2,639

1,462

499

1,785

3,930

981

No Method
Partner pregnant/seeking pregnancy
Other reason
Method Unknown

e

Family Planning Annual Report: 2014 National Summary

20,628

754

342

11,475

1,821

2,541

1,702

511

184

1,264

34

Total Male Users

364,661

23,831

37,139

53,165

23,865

32,563

25,267

11,692

18,669

126,711

11,759

Using a Method

319,279

20,656

34,006

38,289

19,647

27,281

21,918

10,551

16,435

119,845

10,651

Not Using a Method

24,754

2,421

2,791

3,401

2,397

2,741

1,647

630

2,050

5,602

1,074

Method Unknown

20,628

754

342

11,475

1,821

2,541

1,702

511

184

1,264

34

e

FAM=fertility awareness-based method.
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.

a

b
c
d

e

User refrained from oral, vaginal, and anal intercourse.
Includes withdrawal or any other method not listed in FPAR Table 8.
Primary method of user’s sex partner was female sterilization, intrauterine device, hormonal implant, hormonal injection, oral contraceptive, contraceptive patch, vaginal ring,
female barrier method (cervical cap, diaphragm, sponge, female condom), spermicide, or the lactational amenorrhea method.
See Table 8 comments in the Field and Methodological Notes (Appendix C).

Family Planning Annual Report: 2014 National Summary

Exhibit 25. Distribution of male family planning users, by primary contraceptive method and region: 2014 (Source: FPAR Table 8)
All
Regions

Primary Method
Vasectomy
Male condom
FAM a
Abstinence

Region I

1%

1%

72%

61%

0%†

0%†

Region II
0%†
79%

Region III
0%†
59%

Region IV
3%
56%

Region V
0%†
74%

Region VI

Region VII Region VIII Region IX

Region X

1%

1%

2%

1%

2%

72%

74%

60%

83%

52%

0%†

0%†

1%

0%†

2%

0%†

0%†

0%†

0%†

10%

3%

7%

3%

5%

3%

26%

6%

15%

2%

5%

3%

2%

4%

4%

2%

1%

3%

2%

1%

3%

4%

6%

7%

6%

4%

10%

5%

2%

11%

20%

5%

6%

Partner pregnant/seeking pregnancy

1%

2%

0%†

0%†

0%†

1%

1%

1%

1%

1%

Other reason

6%

8%

7%

6%

8%

6%

4%

10%

3%

8%

b

Withdrawal or other method

c

Rely on female method d
No Method

Method Unknown

e

0%†
10%

6%

3%

1%

22%

8%

8%

7%

4%

1%

1%

Total Male Users

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Using a Method

88%

87%

92%

72%

82%

84%

87%

90%

88%

95%

91%

Not Using a Method

7%

10%

8%

6%

10%

8%

7%

5%

11%

4%

9%

Method Unknown

6%

3%

1%

22%

8%

8%

7%

4%

1%

1%

0%†

e

FAM=fertility awareness-based method.
Note: Due to rounding, percentages may not sum to 100%.
a
FAMs include Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and SymptoThermal methods.
b
User refrained from oral, vaginal, and anal intercourse.
c
Includes withdrawal or any other method not listed in FPAR Table 8.
d
Primary method of user’s sex partner was female sterilization, intrauterine device, hormonal implant, hormonal injection, oral contraceptive, contraceptive patch, vaginal ring,
female barrier method (cervical cap, diaphragm, sponge, female condom), spermicide, or the lactational amenorrhea method.
e
See Table 8 comments in the Field and Methodological Notes (Appendix C).
† Percentage is less than 0.5%.

0%†

39

Guidance for Reporting Cervical and Breast Cancer Screening Activities in FPAR Tables 9 and 10
In FPAR Table 9, grantees report the following information on cervical cancer screening activities:

• Unduplicated number of female users who obtained a Pap test;
• Number of Pap tests performed;
• Number of Pap tests with an ASC or higher result according to the 2001 Bethesda System;16 ASC or higher
results include ASC-US; ASC-H; LSIL; HSIL; squamous cell carcinoma; AGC; AGC, favor neoplastic; AIS;
adenocarcinoma; or other (e.g., endometrial cells in a woman ≥ 40 years of age); and

• Number of Pap tests with an HSIL or higher result according to the 2001 Bethesda System;16 HSIL or higher
results include HSIL; squamous cell carcinoma; AGC; AGC, favor neoplastic; AIS; adenocarcinoma; or other
(e.g., endometrial cells in a woman ≥ 40 years of age).

In FPAR Table 10, grantees report the following information on breast health screening and referral activities:

• Unduplicated number of female users receiving a clinical breast exam (CBE).
• Unduplicated number of female users referred for further evaluation based on CBE results.
The FPAR instructions provide the following guidance for reporting this information:
Tests—Report Pap tests and CBEs performed during the reporting period that are provided within the scope of the
agency’s Title X project.
Atypical Squamous Cells (ASC)—ASC refers to cytological changes that are suggestive of a squamous
intraepithelial lesion. The 2001 Bethesda System16 subdivides atypical squamous cells into two categories:

• Atypical squamous cells of undetermined significance (ASC-US)—ASC-US refers to cytological changes that are
suggestive of a squamous intraepithelial lesion, but lack criteria for a definitive interpretation.17

• Atypical squamous cells, cannot exclude HSIL (ASC-H)—ASC-H refers to cytological changes that are
suggestive of a high-grade squamous intraepithelial lesion (HSIL), but lack criteria for a definitive
interpretation.17

Low-Grade Squamous Intraepithelial Lesions (LSIL)—LSIL refers to low-grade squamous intraepithelial lesions
encompassing human papillomavirus, mild dysplasia, and cervical intraepithelial neoplasia (CIN) 1.17
High-Grade Squamous Intraepithelial Lesions (HSIL)—HSIL refers to high-grade squamous intraepithelial lesions
encompassing moderate and severe dysplasia, carcinoma in situ, CIN 2, and CIN 3.17
Atypical Glandular Cells (AGC)—AGC refers to glandular cell abnormalities, including adenocarcinoma. The 2001
Bethesda System (see Exhibit 1 of the Title X FPAR: Forms and Instructions) classifies AGC less severe than
adenocarcinoma into three categories.18

• Atypical glandular cells, either endocervical, endometrial, or “glandular cells” not otherwise specified;
• Atypical glandular cells, either endocervical or “glandular cells” favor neoplasia (AGC, favor neoplastic); and
• Endocervical adenocarcinoma in situ (AIS).
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 33–35.

40

Family Planning Annual Report: 2014 National Summary

CERVICAL AND BREAST CANCER SCREENING
According to the QFP Recommendations,15 providers should assess clients’ need for related
preventive health services (e.g., cervical and breast cancer screening) and provide these
services according to federal and professional recommendations regarding frequency, client
eligibility, and procedures. This assessment is especially important for clients whose only
source of health care is the Title X service site.
Cervical Cancer Screening (Exhibit 26)

In 2014, Title X service sites provided Papanicolaou (Pap) testing to 21% (785,540) of female
family planning users and performed 813,858 Pap tests (average of 2.2 tests per 10 female
users) (Exhibit 26). Additional results include the following:

▪ Of the Pap tests performed, 14% had an indeterminate or abnormal result (i.e., atypical
squamous cell [ASC] or higher result) requiring further evaluation and possible
treatment. One percent of Pap tests had a result of high-grade squamous intraepithelial
lesion (HSIL) or higher, indicating the presence of a more severe condition.

▪ By region, the percentage of total female users who received a Pap test ranged from

16% (IX) to 29% (VI). Ten percent (IX) to 16% (III, V, and X) of Pap tests had an ASC
or higher result, and 1% to 2% had an HSIL or higher result.

In 2014, the percentage of female users who received a Pap test (21%) was substantially
lower than in 2005 (52%), which was the first year these data were collected (Exhibits A–9a
and A–9b). The downward trend in cervical cancer screening is attributed to adoption of
national screening recommendations, which have increased both the age at which Pap testing
should begin and the testing interval for women with a normal result.
Breast Cancer Screening (Exhibit 26)

In 2014, Title X service sites provided clinical breast exams (CBEs) to 31% (1.3 million) of
female users and referred 4% (46,892) of those examined for further evaluation based on
CBE results. By region, from 14% (IX) to 48% (IV and VI) of total users received a CBE,
and 1% (VIII and X) to 13% (IX) of those examined were referred for further evaluation
(Exhibit 26).

Family Planning Annual Report: 2014 National Summary

41

Exhibit 26. Cervical and breast cancer screening activities, by screening test or exam and region: 2014 (Source: FPAR Tables 9 and 10)

42

Tests/Exams
Pap Tests
Users tested
Number a
Percentage

b

Tests performed
Number
Tests per 10 users
ASC or higher result
Number
Percentage c
HSIL or higher result
Number

Family Planning Annual Report: 2014 National Summary

Percentage

c

Clinical Breast Exams
Users examined
Number d
Percentage

e

Users referred based on exam
Number
Percentage

f

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region IX

Region X

785,540

28,680

94,378

84,299

183,848

63,279

78,279

34,547

24,077

167,810

26,343

21%

18%

24%

20%

25%

18%

29%

25%

20%

16%

17%

813,858

30,219

96,737

86,635

190,962

64,908

80,027

35,295

25,350

177,159

26,566

2.2

1.9

2.5

2.1

2.6

1.9

2.9

2.6

2.1

1.7

1.7

112,457

4,065

13,706

13,948

14%

13%

14%

16%

29,445

10,116

10,755

5,421

3,432

17,208

4,361

15%

16%

13%

15%

14%

10%

16%

8,860

483

841

1,094

2,495

983

950

373

242

1,062

337

1%

2%

1%

1%

1%

2%

1%

1%

1%

1%

1%

1,265,920

45,178

142,280

145,052

370,330

102,477

143,697

65,215

54,991

158,806

37,894

31%

25%

33%

31%

48%

27%

48%

44%

40%

14%

23%

46,892

1,833

2,777

5,170

7,943

3,214

3,540

1,519

459

20,187

250

4%

4%

2%

4%

2%

3%

2%

2%

1%

13%

1%

ASC=atypical squamous cells. HSIL=high-grade squamous epithelial lesion.
a
Unduplicated number of female users.
b
Denominator is the total unduplicated number of female users.
c
Denominator is the total number of Pap tests performed.
d
Unduplicated number of female and male users.
e
Denominator is the total unduplicated number of users (female and male).
f
Denominator is the total unduplicated number of users examined.

Region VII Region VIII

SEXUALLY TRANSMITTED DISEASE TESTING
Sexually transmitted diseases (STDs) are a concern for clients served in Title X service
projects, particularly young (15 to 24) sexually active women who have the highest reported
rates of chlamydia and gonorrhea.19 According to the QFP Recommendations,15 STD services
are integral to family planning services because they improve health and can affect a person’s
ability to conceive and have a healthy birth outcome. The QFP Recommendations advise
providers to offer STD services to clients, both symptomatic and asymptomatic, in
accordance with CDC’s STD treatment20 and HIV testing guidelines.21
Chlamydia Testing (Exhibits 27 and 28)

CDC recommends routine annual chlamydia screening for all sexually active women under
25, for older women at increased risk of infection (e.g., with a new or multiple sex partners, a
sex partner with concurrent partners, or sexual partner with an STD), and for sexually active
women with HIV at the first HIV evaluation and at least annually thereafter unless risk
behaviors and the local epidemiology warrant more frequent screening.20 The 2014 results for
female chlamydia testing are as follows:

▪ Title X service sites tested 48% (1.8 million) of all female users for chlamydia and 58%
(1.0 million) of female users under 25 (Exhibits 27 and 28).

▪ By age group, chlamydia testing rates were higher for females 15 to 24 (57% to 59%)
than those under 15 (41%) or over 24 (40%) (Exhibits 27 and 28).

▪ By region, chlamydia testing rates for females under 25 ranged from 49% (IV) to 70%

(IX) and were at or above the national rate of 58% in Regions VI, VII, and IX (Exhibits
27 and 28).

▪ By state, chlamydia testing rates for females under 25 ranged from 5% to 84% (Exhibit
B–5).

▪ In 2014, the percentage of females under 25 tested for chlamydia was 58% compared
with 50% in 2005 (the first year data were available) (Exhibits A–10a and A–10b).

CDC recommends that providers consider screening young men for chlamydia in highprevalence clinical settings (e.g., adolescent clinics, correctional facilities, and STD clinics)
or in populations with a high burden of infection (e.g., men who have sex with men [MSM]).
CDC also recommends screening sexually active MSM at anatomic sites of contact (urethral
and rectal) at least annually or every 3 to 6 months if at increased risk and sexually active
men with HIV at the first HIV evaluation and at least annually thereafter unless risk behaviors
and the local epidemiology warrant more frequent screening.20 The 2014 results for male
chlamydia testing are as follows (Exhibits 27 and 28):

▪ Title X service sites tested 66% (241,809) of all male users for chlamydia.
▪ By age group, rates of chlamydia testing were highest for males 18 or over (65% to
77%) and lowest for males under 15 (16%).

▪ By region, Title X service sites tested 32% (VI) to 78% (V and IX) of all male users for
chlamydia.

Family Planning Annual Report: 2014 National Summary

43

Gonorrhea Testing (Exhibit 29)

CDC recommends annual gonorrhea screening for all sexually active women under 25 and for
older women at increased risk of infection (e.g., new or multiple sex partners, a sex partner
with concurrent partners, a sex partner who has an STD, inconsistent condom use among
persons who are not in mutually monogamous relationships, previous or coexisting STDs,
and exchanging sex for drugs or money). CDC also recommends screening sexually active
MSM at anatomic sites of contact (urethra, rectum, and pharynx) at least annually or every 3
to 6 months if at increased risk. Finally, CDC recommends screening sexually active persons
with HIV at the first HIV evaluation and at least annually thereafter unless individual risk
behaviors and the local epidemiology warrant more frequent screening.20 The 2014 results for
female and male gonorrhea testing are as follows (Exhibit 29):

▪ Title X service sites performed over 2.2 million gonorrhea tests (2.0 million female

tests and 271,201 male tests). On average, sites performed 5.2 gonorrhea tests for every
10 female users and 7.4 tests for every 10 male users.

▪ By region, the rate of gonorrhea testing ranged from 3.5 (VIII) to 6.1 (IX) tests for
every 10 female users and from 3.9 (IV) to 9.0 (IX) tests for every 10 male users.

Syphilis Testing (Exhibit 29)

CDC recommends screening sexually active MSM at least annually or every 3 to 6 months if
at increased risk. CDC also recommends screening sexually active persons with HIV at the
first HIV evaluation and at least annually thereafter unless individual risk behaviors and the
local epidemiology warrant more frequent screening.20 The 2014 results for female and male
syphilis testing are as follows (Exhibit 29):

▪ Title X service sites performed 590,115 syphilis tests (468,980 female tests and 121,135
male tests). On average, sites performed 1.2 syphilis tests for every 10 female users and
3.3 tests for every 10 male users.

▪ By region, the rate of syphilis testing ranged from 0.1 tests (VIII) to 2.4 tests (VI) for

every 10 female users and from 0.7 tests (VIII) to 4.5 tests (VI) for every 10 male users.

Human Immunodeficiency Virus Testing (Exhibit 29)

CDC recommends HIV screening (opt-out approach) for men and women 13 to 64 in all
health care settings, including family planning, and for men and women who seek evaluation
and treatment for STDs. CDC also recommends HIV screening at least annually for sexually
active MSM if their HIV status is unknown or negative and the client himself or his partner(s)
has had more than one sex partner since the most recent HIV test.20,21

44

Family Planning Annual Report: 2014 National Summary

The 2014 results for female and male HIV testing are as follows (Exhibit 29):

▪ Title X service sites performed over 1.0 million confidential HIV tests (822,723 female
tests and 208,901 male tests) and 1,458 anonymous HIV tests. On average, sites
performed 2.2 confidential HIV tests for every 10 female users and 5.7 tests for every
10 male users. Of the confidential HIV tests performed, 2,112 were positive for HIV.

▪ By region, the rate of HIV testing ranged from 0.8 tests (X) to 3.2 tests (II) for every 10
female users and from 3.0 (X) to 6.9 tests (IX) for every 10 male users.

Since 2004, the HIV testing rate for Title X service sites increased, growing from 1.0 test per
10 users in 2004 to 2.5 tests per 10 users in 2014 (Exhibits A–11a and A–11b).

Guidance for Reporting STD Testing Activities in FPAR Tables 11 and 12
In FPAR Tables 11 and 12, grantees report testing information for chlamydia (Table 11), gonorrhea (Table 12),
syphilis (Table 12), and HIV (Table 12).
In FPAR Table 11, grantees report the unduplicated number of family planning users tested for chlamydia, by age
group (< 15, 15–17, 18–19, 20–24, and 25 or over) and sex.
In FPAR Table 12, grantees report the following information on gonorrhea, syphilis, and HIV testing:

•
•
•
•
•

Number of gonorrhea tests performed, by sex;
Number of syphilis tests performed, by sex;
Number of confidential HIV tests performed, by sex;
Number of confidential HIV tests with a positive result; and
Number of anonymous HIV tests performed.

The FPAR instructions provide the following guidance for reporting this information:
Age Group—Use the client’s age as of June 30 of the reporting period.
Tests—Report STD (chlamydia, gonorrhea, and syphilis) and HIV (confidential and anonymous) tests performed
during the reporting period that are provided within the scope of the grantee’s Title X project. Do not report tests
performed in an STD clinic operated by the Title X-funded agency, unless the activities of the STD clinic are within
the defined scope of the agency’s Title X project.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), p. 39.

Family Planning Annual Report: 2014 National Summary

45

Exhibit 27. Number of family planning users tested for chlamydia, by sex, age, and region: 2014 (Source: FPAR Table 11)

46

Age Group (Years)

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Female Users
Under 15

15,095

714

1,178

2,707

3,205

1,339

1,435

639

423

2,661

794

15 to 17

155,861

7,045

14,400

19,089

25,667

13,777

12,625

6,454

5,703

42,355

8,746

18 to 19

222,948

8,795

20,246

24,840

35,074

18,988

16,267

8,649

8,105

72,151

9,833

20 to 24

617,570

23,731

58,000

54,951

104,272

52,236

45,229

22,922

18,881

213,536

23,812

Over 24

810,826

36,429

104,364

81,874

145,040

61,827

63,946

26,901

13,092

251,900

25,453

1,822,300

76,714

198,188

183,461

313,258

148,167

139,502

65,565

46,204

582,603

68,638

1,011,474

40,285

93,824

101,587

168,218

86,340

75,556

38,664

33,112

330,703

43,185

Under 15

1,441

241

115

541

80

76

18

30

37

278

25

15 to 17

11,838

1,240

1,236

2,820

425

872

274

385

466

3,695

425

18 to 19

19,816

1,209

2,265

3,330

787

1,972

644

694

1,057

7,344

514

20 to 24

75,373

4,449

8,845

9,220

2,677

8,230

2,371

2,798

4,293

30,464

2,026

Over 24

133,341

7,611

13,582

14,894

5,164

14,205

4,883

4,341

8,499

56,439

3,723

Subtotal

241,809

14,750

26,043

30,805

9,133

25,355

8,190

8,248

14,352

98,220

6,713

Subtotal
Under 25

a

Male Users

Family Planning Annual Report: 2014 National Summary

All Users
Under 15

16,536

955

1,293

3,248

3,285

1,415

1,453

669

460

2,939

819

15 to 17

167,699

8,285

15,636

21,909

26,092

14,649

12,899

6,839

6,169

46,050

9,171

18 to 19

242,764

10,004

22,511

28,170

35,861

20,960

16,911

9,343

9,162

79,495

10,347

20 to 24

692,943

28,180

66,845

64,171

106,949

60,466

47,600

25,720

23,174

244,000

25,838

944,167

44,040

117,946

96,768

150,204

76,032

68,829

31,242

21,591

308,339

29,176

2,064,109

91,464

224,231

214,266

322,391

173,522

147,692

73,813

60,556

680,823

75,351

Over 24
Total All Users
a

The U.S. Centers for Disease Control and Prevention (CDC) recommends routine annual chlamydia screening for all sexually active women 24 years or younger and for older
women at increased risk of infection (e.g., with a new or multiple sex partners, a sex partner with concurrent partners, or sexual partner with an STD). The U.S. Preventive Services
Task Force (USPSTF) recommends screening for chlamydial infection in sexually active women 24 years or younger and in older women who are at increased risk for infection. In
the absence of studies on screening intervals, the USPSTF recommends rescreening women whose sexual history reveals new or persistent risk factors since the last negative
test result. (Sources: CDC [2015]. Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(No. RR–3), 1–137 [See reference 20] and USPSTF [2014, September].
Gonorrhea and chlamydia: Screening [See reference 22])

Family Planning Annual Report: 2014 National Summary

Exhibit 28. Percentage of family planning users in each age group tested for chlamydia, by sex, age, and region: 2014 (Source: FPAR Table 11)
Age Group (Years)

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Under 15

41%

29%

39%

46%

38%

40%

39%

41%

29%

53%

47%

15 to 17

57%

49%

58%

53%

48%

50%

60%

58%

52%

71%

58%

18 to 19

59%

56%

58%

60%

48%

50%

61%

60%

53%

72%

59%

20 to 24

58%

57%

55%

50%

50%

50%

62%

60%

52%

69%

56%

Over 24

40%

42%

47%

37%

36%

36%

43%

38%

24%

46%

33%

48%

48%

51%

44%

42%

43%

51%

48%

39%

57%

45%

58%

54%

56%

52%

49%

50%

61%

59%

52%

70%

57%

Under 15

16%

21%

13%

24%

5%

15%

2%

19%

9%

24%

32%

15 to 17

49%

40%

49%

45%

25%

53%

26%

62%

44%

64%

76%

18 to 19

70%

67%

71%

66%

48%

80%

34%

72%

75%

80%

82%

20 to 24

77%

79%

78%

71%

51%

84%

37%

77%

81%

86%

74%

Over 24

65%

63%

71%

56%

38%

79%

32%

69%

81%

75%

48%

Subtotal

66%

62%

70%

58%

38%

78%

32%

71%

77%

78%

57%

Under 15

36%

27%

33%

40%

33%

37%

31%

39%

24%

47%

47%

15 to 17

56%

48%

58%

52%

47%

51%

58%

58%

51%

70%

58%

18 to 19

60%

57%

59%

61%

48%

52%

59%

61%

55%

72%

60%

20 to 24

59%

60%

57%

52%

50%

52%

60%

61%

56%

71%

57%

Female Users

Subtotal
Under 25

a

Male Users

All Users

a

Over 24

43%

45%

48%

39%

36%

40%

42%

40%

33%

49%

34%

Total All Users

50%

50%

52%

46%

42%

46%

50%

50%

44%

59%

45%

The U.S. Centers for Disease Control and Prevention (CDC) recommends routine annual chlamydia screening for all sexually active women 24 years or younger and for older
women at increased risk of infection (e.g., with a new or multiple sex partners, a sex partner with concurrent partners, or sexual partner with an STD). The U.S. Preventive Services
Task Force (USPSTF) recommends screening for chlamydial infection in sexually active women 24 years or younger and in older women who are at increased risk for infection. In
the absence of studies on screening intervals, the USPSTF recommends rescreening women whose sexual history reveals new or persistent risk factors since the last negative
test result. (Sources: CDC [2015]. Sexually transmitted diseases treatment guidelines, 2015. MMWR, 64(No. RR–3), 1–137 [See reference 20] and USPSTF [2014, September].
Gonorrhea and chlamydia: Screening [See reference 22])

47

48

Exhibit 29. Number of gonorrhea, syphilis, and HIV tests performed, by test type and region, and number of positive HIV tests, by region:
2014 (Source: FPAR Table 12)
STD Tests

All Regions

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

Gonorrhea Tests
Female

1,966,864

81,411

228,174

208,121

323,375

167,978

153,570

68,637

41,712

620,448

73,438

Male

271,201

15,544

30,448

30,858

9,212

27,885

14,006

8,789

13,408

113,973

7,078

Total

2,238,065

96,955

258,622

238,979

332,587

195,863

167,576

77,426

55,120

734,421

80,516

Tests per 10 Users
Female

5.2

5.1

5.8

5.0

4.3

4.9

5.6

5.0

3.5

6.1

4.8

Male

7.4

6.5

8.2

5.8

3.9

8.6

5.5

7.5

7.2

9.0

6.0

Total

5.4

5.3

6.0

5.1

4.3

5.2

5.6

5.2

4.0

6.4

4.9

Syphilis Tests

Family Planning Annual Report: 2014 National Summary

Female

468,980

13,484

40,481

67,541

156,708

13,836

65,592

15,145

1,282

90,630

4,281

Male

121,135

5,857

12,448

21,500

7,402

7,922

11,400

4,353

1,232

47,109

1,912

Total

590,115

19,341

52,929

89,041

164,110

21,758

76,992

19,498

2,514

137,739

6,193

Tests per 10 Users
Female

1.2

0.8

1.0

1.6

2.1

0.4

2.4

1.1

0.1

0.9

0.3

Male

3.3

2.5

3.4

4.0

3.1

2.4

4.5

3.7

0.7

3.7

1.6

Total

1.4

1.1

1.2

1.9

2.1

0.6

2.6

1.3

0.2

1.2

0.4

822,723

30,304

124,973

94,799

163,659

65,063

85,035

23,274

11,690

211,412

12,514

Confidential HIV Tests
Female
Male

208,901

12,199

24,147

29,466

8,380

16,572

13,271

4,951

9,116

87,261

3,538

Total

1,031,624

42,503

149,120

124,265

172,039

81,635

98,306

28,225

20,806

298,673

16,052

Female

2.2

1.9

3.2

2.3

2.2

1.9

3.1

1.7

1.0

2.1

0.8

Male

5.7

5.1

6.5

5.5

3.5

5.1

5.3

4.2

4.9

6.9

3.0

Total

2.5

2.3

3.5

2.7

2.2

2.2

3.3

1.9

1.5

2.6

1.0

Positive Test Results

2,112

67

279

239

341

80

413

32

24

623

14

Anonymous HIV Tests

1,458

0

0

926

1

145

0

32

0

350

4

Tests per 10 Users

STAFFING AND FAMILY PLANNING ENCOUNTERS
Clinical Services Provider Staffing (Exhibit 30)

Highly trained clinical services providers (CSPs) participate in the delivery of Title X-funded
services. CSPs include physicians, physician assistants (PAs), nurse practitioners (NPs),
certified nurse midwives (CNMs), and registered nurses with an expanded scope of practice
(“other” CSPs) who are trained and permitted by state-specific regulations to perform exams
and medical procedures as described in the Program Requirements for Title X Funded Family
Planning Projects1 and the QFP Recommendations.15
In 2014, 3,066 full-time equivalent (FTE) CSPs delivered medical family planning and
related preventive health services in Title X service sites (Exhibit 30). Additional results
include the following:

▪ Midlevel clinicians (i.e., PAs, NPs, and CNMs) accounted for 67% of total FTEs,
followed by physicians (18%) and other CSPs (15%). On average, there were 3.6
midlevel clinician FTEs for every 1.0 physician FTE.

▪ By region, 9% (IV and VIII) to 27% (III and VI) of total FTEs were physician FTEs,

46% (IV) to 84% (VII and VIII) were midlevel clinician FTEs, and 0% (I, VI, VII, and
X) to 45% (IV) were other CSP FTEs.
– There were from 2.4 (III) to 9.1 (VIII) midlevel clinician FTEs for every 1.0
physician FTE.

– In Region IV, midlevel clinicians and other CSPs accounted for almost the same
share of total CSP FTEs, 46% and 45%, respectively.
Family Planning Encounters (Exhibit 30)

In 2014, Title X service sites reported a total of 7.2 million family planning encounters, or an
average of 1.7 encounters per family planning user (Exhibit 30). Additional results include
the following:

▪ Most (5.1 million or 71%) encounters were attended by a CSP, resulting in an average
of 1.2 CSP encounters per user and 1,676 CSP encounters per CSP FTE.

▪ By region, encounters with a CSP accounted for 56% (IV) to 89% (II) of all family
planning encounters.

– The number of total encounters per user ranged from 1.5 (X) to 2.0 (V and VII).
– The number of CSP encounters per user ranged from 1.0 (IV and VIII) to 1.5 (II),
and the number of CSP encounters per CSP FTE ranged from 1,022 (IV) to 2,569
(IX).

Family Planning Annual Report: 2014 National Summary

49

Guidance for Reporting Encounter and Staffing Data in FPAR Table 13
In FPAR Table 13, grantees report information on the number and type of family planning encounters and the use of
clinical services providers to deliver Title X-funded family planning and related preventive health services. Table 13
reports the following provider staffing and encounter data:

• Number of full-time equivalent (FTE) family planning clinical services providers by type of provider,
• Number of family planning encounters with clinical services providers, and
• Number of family planning encounters with other services providers.
The FPAR instructions provide the following guidance for reporting this information:
Family Planning Provider—A family planning provider is the individual who assumes primary responsibility for
assessing a client and documenting services in the client record. Providers include those agency staff who exercise
independent judgment as to the services rendered to the client during an encounter. Two general types of providers
deliver Title X family planning services: clinical services providers and other services providers.
Clinical Services Providers—Include physicians (family and general practitioners, specialists), physician
assistants, nurse practitioners, certified nurse midwives, and registered nurses with an expanded scope of practice
who are trained and permitted by state-specific regulations to perform all aspects of the user (male and female)
physical assessment, as described in the Program Guidelines. Clinical services providers are able to offer client
education, counseling, referral, followup, and clinical services (physical assessment, treatment, and management)
relating to a client’s proposed or adopted method of contraception, general reproductive health, or infertility
treatment, in accordance with the Program Guidelines.
Other Services Providers—Include other agency staff (e.g., registered nurses, public health nurses, licensed
vocational or licensed practical nurses, certified nurse assistants, health educators, social workers, or clinic aides)
that offer client education, counseling, referral, or followup services relating to the client’s proposed or adopted
method of contraception, general reproductive health, or infertility treatment, as described in the Program
Guidelines. Other services providers may also perform or obtain samples for routine laboratory tests (e.g., urine,
pregnancy, STD, and cholesterol and lipid analysis), give contraceptive injections (e.g., Depo-Provera), and
perform routine clinical procedures that may include some aspects of the user physical assessment (e.g., blood
pressure evaluation), in accordance with the Program Guidelines.
Family Planning Encounter—A family planning encounter is a documented, face-to-face contact between an
individual and a family planning provider that takes place in a Title X service site. The purpose of a family planning
encounter—whether clinical or nonclinical—is to provide family planning and related preventive health services to
female and male clients who want to avoid unintended pregnancies or achieve intended pregnancies. To be counted
for purposes of the FPAR, a written record of the service(s) provided during the family planning encounter must be
documented in the client record. There are two types of family planning encounters at Title X service sites: (1) family
planning encounters with a clinical services provider and (2) family planning encounters with an other services
provider. The type of family planning provider who renders the care, regardless of the services rendered, determines
the type of family planning encounter. Although a client may meet with both clinical and other services providers
during an encounter, the provider with the highest level of training who takes ultimate responsibility for the client’s
clinical or nonclinical assessment and care during the visit is credited with the encounter.
Family Planning Encounter with a Clinical Services Provider—A face-to-face, documented encounter between
a family planning client and a clinical services provider that takes place in a Title X service site.
Family Planning Encounter with an Other Services Provider—A face-to-face, documented encounter between
a family planning client and an other services provider that takes place in a Title X service site.
Laboratory tests and related counseling and education, in and of themselves, do not constitute a family planning
encounter unless there is face-to-face contact between the client and provider, the provider documents the encounter
in the client’s record, and the tests are accompanied by family planning counseling or education.
Full-Time Equivalent (FTE)—For each type of clinical services provider, report the time in FTEs that these providers
are involved in the direct provision of Title X-funded services (i.e., engaged in a family planning encounter).
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 43–45.

50

Family Planning Annual Report: 2014 National Summary

Family Planning Annual Report: 2014 National Summary

Exhibit 30. Number and distribution of FTE CSP staff, by type of CSP and region, and number and distribution of FP encounters, by type of
encounter and region: 2014 (Source: FPAR Table 13)
All
Regions

FTEs and FP Encounters
Number of CSP FTEs
Physician
PA/NP/CNM
Other CSP

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

563.5

26.4

66.5

123.9

69.6

52.4

65.4

14.7

7.6

109.1

27.9

2,052.5

110.5

198.7

295.1

351.2

178.1

175.3

78.2

69.5

474.8

121.1

450.2

0.0

11.0

46.4

347.3

34.2

0.0

0.0

5.8

5.5

0.0

3,066.2

136.8

276.2

465.4

768.1

264.7

240.6

92.9

83.0

589.4

149.0

18%

19%

24%

27%

9%

20%

27%

16%

9%

19%

19%

PA/NP/CNM

67%

81%

72%

63%

46%

67%

73%

84%

84%

81%

81%

Other CSP a

15%

0%

4%

10%

45%

13%

0%

0%

7%

1%

0%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

3.6

4.2

3.0

2.4

5.0

3.4

2.7

5.3

9.1

4.4

4.3

5,138,139

259,296

645,662

599,790

785,069

536,817

316,489

168,007

132,341

1,514,289

180,379

With other

2,076,893

36,860

76,938

203,685

628,901

210,782

223,542

126,713

95,214

404,466

69,792

Total

7,215,032

296,156

722,600

803,475

1,413,970

747,599

540,031

294,720

227,555

1,918,755

250,171

71%

88%

89%

75%

56%

72%

59%

57%

58%

79%

72%

29%

12%

11%

25%

44%

28%

41%

43%

42%

21%

28%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

With CSP

1.2

1.4

1.5

1.3

1.0

1.4

1.1

1.1

1.0

1.3

1.1

With other

0.5

0.2

0.2

0.4

0.8

0.6

0.7

0.9

0.7

0.4

0.4

Total

1.7

1.6

1.7

1.7

1.8

2.0

1.8

2.0

1.7

1.7

1.5

1,676

1,895

2,337

1,289

1,022

2,028

1,315

1,808

1,595

2,569

1,210

a

Total
Distribution of CSP FTEs
Physician

Total
Midlevel to Physician FTE

b

Number of FP Encounters
With CSP

Distribution of FP Encounters
With CSP
With other
Total
FP Encounters per User

CSP Encounters per CSP FTE

CNM=certified nurse midwife. CSP=clinical services provider. FP=family planning. FTE=full-time equivalent. NP=nurse practitioner. PA=physician assistant.
Note: Due to rounding, percentages may not sum to 100%.

51

a

Other CSPs are registered nurses with an expanded scope of practice who are trained and permitted by state-specific regulations to perform all aspects of the user (male and
female) physical assessment, as described in the Program Guidelines.

b

Midlevel providers include physician assistants, nurse practitioners, and certified nurse midwives.

This page intentionally left blank.

52

Family Planning Annual Report: 2014 National Summary

REVENUE
In 2014, Title X grantees reported total program revenue of $1.24 billion to support the
delivery of Title X-funded family planning and related preventive health services. The major
sources of revenue—Medicaid ($490.5 million) and Title X ($249.5 million)—accounted for
39% and 20%, respectively, of total revenue. Revenue from state governments
($121.0 million), private third-party payers ($95.1 million), local governments
($80.4 million), and client service fees ($53.2 million) each accounted for 4% to 10% of total
revenue, while all other sources each contributed 2% or less (Exhibit 31).
Title X Services Grant

Revenue from Title X accounted for 20% ($249.5 million) of total national revenue and
between 9% (IX) and 40% (VII) of total regional revenue. Title X was the largest source of
revenue in four regions (I, VI, VII, and VIII) and the second largest single source after
Medicaid in four others (III, IV, V, and IX) (Exhibits 32 and 33).
Payment for Services: Client Fees

Revenue from client service fees accounted for 4% ($53.2 million) of total revenue and
between 2% (IX) and 11% (VIII) of total regional revenue (Exhibits 32 and 33).
Payment for Services: Third-Party Payers

In 2014, revenue from third-party payers was 48% ($601.5 million) of total revenue, with
Medicaid accounting for most (82%) of this amount.
Medicaid and Children’s Health Insurance Program (CHIP). Medicaid revenue (federal
and state shares) accounted for 39% ($490.5 million) of total revenue, and separately reported
CHIP revenue accounted for less than 1% ($2.6 million) of total revenue. Together, these two
sources summed to $493.1 million or 40% of total revenue in 2014.
By region, Medicaid (including CHIP) accounted for 10% (VIII) to 69% (IX) of total regional
revenue. Medicaid was the largest source (29% to 69%) of regional revenue in six regions (II,
III, IV, V, IX, and X) and the second largest source in three others (I, VI, and VII) (Exhibits
32 and 33). Medicaid revenue reported by grantees in 29 states included revenue from state
Medicaid family planning eligibility expansions. (See the FPAR Table 14 notes in Appendix
C: Field and Methodological Notes for a list of the 29 states.)
Medicare and Other Public. Revenue from Medicare ($3.1 million) and other public thirdparty payers ($10.2 million) together accounted for 1% of total national revenue. By region,
the share of revenue from Medicare and other public third-party payers accounted for 1% or
less of total regional revenue in all but Regions I and VI, where it accounted for 3% and 10%,
respectively (Exhibits 32 and 33).
Private. Revenue from private third-party payers ($95.1 million) accounted for 8% of total
national revenue and between 2% (IX) and 20% (I and VII) of total regional revenue. Private
third-party payer revenue was the third most important source in Regions I, V, VII, VIII, and
IX (Exhibits 32 and 33).

Family Planning Annual Report: 2014 National Summary

53

Other Revenue

Block Grants and Temporary Assistance for Needy Families (TANF). Revenue from the
Title V Maternal and Child Health (MCH) block grant ($23.1 million), the Title XX Social
Services block grant ($5.6 million), and TANF ($10.6 million) each accounted for less than
1% to 2% of total national revenue. By region, the share of total regional revenue from block
grants (MCH or Social Services) or TANF ranged between 0% and 4% of total regional
revenues. While all regions reported some revenue from the MCH block grant, only five (I,
III, V, VIII, and IX) reported Social Services block grant revenue and only four (I, IV, V, and
VIII) reported TANF revenue (Exhibits 32 and 33).
State Governments. State government revenue accounted for 10% ($121.0 million) of total
national revenue and from 0.5% (IX) to 23% (II) of total regional revenue. State government
revenue was the second largest source of project revenue in Regions II (23%) and X (17%),
and the third largest source in Regions III (18%) and VI (14%) (Exhibits 32 and 33).
Local Governments. Local government revenue accounted for 6% ($80.4 million) of total
national revenue and from 0.1% (I) to 23% (VIII) of total regional revenue. Local government
revenue was the second largest source of revenue in Region VIII (23%), after Title X, and the
third largest source in Region IV (16%) after Medicaid and Title X (Exhibits 32 and 33).
Bureau of Primary Health Care. Revenue from the Health Resources Services
Administration (HRSA) Bureau of Primary Health Care (BPHC) accounted for 1%
($10.1 million) of total national revenue. Two regions (III and VIII) reported no BPHC
revenue, while eight others reported BPHC revenue ranging from less than 1% (I, IV, VI, and
VII) to 3% (V) of total regional revenue (Exhibits 32 and 33).
All Other Revenue. Finally, 7% ($89.0 million) of total revenue came from a combination of
all other public and private sources not listed separately in Table 14. Revenue from other
sources ranged from 2% (III, IV, and X) to 15% (IX) of total regional revenue (Exhibits 32
and 33). See the notes for FPAR Table 14 in Appendix C: Field and Methodological Notes
for a list of other revenue sources.
Revenue per User

On average, grantees reported $301 in program revenue per user served in 2014. By region,
revenue per user ranged from $231 (VII) to $399 (II) and was above the national average
($301) in three regions (II, V, and X) (Exhibit 32).

54

Family Planning Annual Report: 2014 National Summary

Exhibit 31. Amount and distribution of Title X project revenues, by revenue source: 2014
(Source: FPAR Table 14)
Revenue Source

Amount

Title X

Distribution

$249,517,445

20%

$53,170,034

4%

$490,470,842

39%

Payment for Services
Client fees
Third-party payers

a

Medicaid b
Medicare
Children’s Health Insurance Program

$3,083,719

0%†

$2,590,621

0%†

Other public

$10,202,966

1%

Private

$95,138,355

8%

Subtotal

$654,656,537

53%

$23,095,828

2%

$5,601,590

0%†

$10,570,729

1%

State government

$120,974,720

10%

Local government

$80,388,864

6%

Bureau of Primary Health Care

$10,080,722

1%

Other

$89,015,512

7%

$339,727,965

27%

$1,243,901,947

100%

Other Revenue
Maternal and Child Health block grant
Social Services block grant
Temporary Assistance for Needy Families

c

Subtotal
Total Revenue
Total Revenue 2004$

d

$886,133,687

Total Revenue 1981$

d

$236,892,882

—

$301

—

Total Revenue per User

—

— Not applicable.
Note: Unless otherwise noted, revenue is shown in actual dollars (unadjusted) for each year. Due to rounding, percentages may
not sum to 100%.
a
Prepaid and not prepaid.
b
Includes revenue from Medicaid family planning eligibility expansions in 29 states in all 10 HHS regions. See Table 14
comments in the Field and Methodological Notes (Appendix C) for a list of states by region.
c
See Table 14 comments in the Field and Methodological Notes (Appendix C) for a list of the types of revenue reported as
“other.”
d
Revenue is shown in constant 2004 dollars (2004$) or 1981 dollars (1981$), based on the consumer price index for medical
care, which includes medical care commodities and medical care services (Source: U.S. Department of Labor, Bureau of Labor
Statistics, Series ID. CUUR0000SAM, http://data.bls.gov/cgi-bin/srgate).
† Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

55

Guidance for Reporting Project Revenue in FPAR Table 14
In FPAR Table 14, grantees report the revenues (i.e., actual cash receipts or drawdown amounts) received during the
reporting period from each funding source to support activities within the scope of the grantee’s Title X services grant
(Section 1001), even if the funds were not expended during the reporting period. Grantees are instructed not to report
the monetary value of in-kind contributions as revenue in Table 14. The FPAR instructions provide the following
guidance for reporting this information:
Title X Grant (Row 1)—Refers to funds received from the Title X Section 1001 family planning services grant. Report
the amount received (cash receipts or drawdown amounts) during the reporting period from the Title X services grant.
Include base Title X grant funding and other Title X funding for special initiatives (e.g., HIV integration and male
involvement). Do not report the amount of grant funds awarded unless this figure is the same as the actual cash
receipts or drawdown amounts.
Payment for Services (Rows 2–5)—Refers to funds collected directly from clients and revenues received from public
and private third-party payers (capitated or fee-for-service) for services provided within the scope of the grantee’s Title
X project.
Total Client Collections/Self-Pay (“Client Fees”) (Row 2)—Report the amount collected directly from clients during
the reporting period for services provided within the scope of the grantee’s Title X project.
Third-Party Payers (Rows 3a–3e)—For each third-party source listed, report the amount received (i.e., reimbursed)
during the reporting period for services provided within the scope of the grantee’s Title X project. Only revenue from
prepaid (capitated) managed care arrangements (e.g., capitated Medicare, Medicaid, and private managed care
contracts) should be reported as prepaid. Revenues received after the date of service, even under managed care
arrangements, should be reported as not prepaid.
Medicaid/Title XIX (Row 3a)—Report the amount received from Medicaid (federal and state shares) during the
reporting period for services provided within the scope of the grantee’s Title X project, regardless of whether the
reimbursement was paid directly by Medicaid or through a fiscal intermediary or a health maintenance organization
(HMO). For example, in states with a capitated Medicaid program (i.e., the grantee has a contract with a private
plan like Blue Cross), the payer is Medicaid, even though the actual payment may come from Blue Cross. Include
revenue from family planning waivers (both federal and state shares) in Row 3a, Column B. If the amount reported
in Row 3a, Column B includes family planning waiver revenue, indicate this in the Table 14 “Notes” field.
Medicare/Title XVIII (Row 3b)—Report the amount received from Medicare during the reporting period for services
provided within the scope of the grantee’s Title X project, regardless of whether the reimbursement was paid
directly by Medicare or through a fiscal intermediary or an HMO. For clients enrolled in a capitated Medicare
program (i.e., where the grantee has a contract with a private plan like Blue Cross), the payer is Medicare, even
though the actual payment may come from Blue Cross.
Children’s Health Insurance Program (CHIP) (Row 3c)—Report the amount of funds received during the
reporting period from CHIP for services provided within the scope of the grantee’s Title X project. If the grantee is
unable to report CHIP revenue separately from Medicaid (Row 3a), indicate this in the Table 14 “Notes” field.
Other Public Health Insurance (Row 3d)—Report the amount reimbursed by other federal, state, or local
government health insurance programs during the reporting period for services provided within the scope of the
grantee’s Title X project. Examples of other public health insurance programs include state or local government
programs that provide a broad set of benefits (e.g., Washington’s Basic Health or Massachusetts’s Commonwealth
Care), including public-paid or public-subsidized private insurance programs.
Private Health Insurance (Row 3e)—Report the amount of funds received from private third-party health
insurance plans during the reporting period for services provided within the scope of the grantee’s Title X project.
Other Revenue (Rows 6–17)—Refers to revenue received from other sources during the reporting period that
supported services provided within the scope of the grantee’s Title X project. Other revenue sources include block
grants, TANF, state and local governments (e.g., contracts, state and local indigent care programs), the Bureau of
Primary Health Care, private and client donations, or other public or private revenues.
Maternal and Child Health (MCH) Block Grant/Title V (Row 6)—Report the amount of Title V funds received
during the reporting period that supported services provided within the scope of the grantee’s Title X project.
Social Services Block Grant/Title XX (Row 7)—Report the amount of Title XX funds received in the reporting
period that supported services provided within the scope of the grantee’s Title X project.
(continued)

56

Family Planning Annual Report: 2014 National Summary

Guidance for Reporting Project Revenue in FPAR Table 14 (continued)
Temporary Assistance for Needy Families (TANF) (Row 8)—Report the amount of TANF funds received in the
reporting period that supported services provided within the scope of the grantee’s Title X project.
Local Government Revenue (Row 9)—Report the amount of funds from local government sources (including
county and city grants or contracts) that were received during the reporting period and that supported services
provided within the scope of the grantee’s Title X project.
State Government Revenue (Row 10)—Report the amount of funds from state government sources (including
grants or contracts) that were received during the reporting period and that supported services provided within the
scope of the grantee’s Title X project. Do not report as “state government revenue” funding from sources like the
Centers for Disease Control and Prevention (CDC) (e.g., Infertility Prevention Project) or block grant funds that are
awarded to and distributed by the state. Report these revenues as “Other revenue” and specify their sources.
Bureau of Primary Health Care (BPHC) (Row 11)—Report the amount of revenue received from BPHC grants
(e.g., Section 330) during the reporting period that supported services provided within the scope of the grantee’s Title
X project.
Other Revenue (Row 12–16)—Report the amount and specify the source of funds received during the reporting
period from other sources that supported services provided within the scope of the grantee’s Title X project. This may
include revenue from such sources as CDC (infertility, STD, or HIV prevention; breast and cervical cancer detection),
private grants and donations, fundraising, interest income, or other sources.
Source: Title X Family Planning Annual Report: Forms and Instructions (Reissued October 2013), pp. 47–49.

Revenue Trends

From 2004 to 2014, inflation-adjusted (constant 2014 dollars)23 total revenue decreased
10%, from $1.38 billion in 2004 to $1.24 billion in 2014 (Exhibit A–12a). The change in
total revenue masked larger shifts in different sources of Title X project revenue. To ease
comparisons, we present all revenue amounts in this section in constant 2014 dollars.
Revenue from Medicaid (including CHIP), the largest source of Title X project funding after
2003, increased 27%, from $389.1 million in 2004 to $493.1 million in 2014 (Exhibit A–
12a). Revenue from private and other third-party payers increased by 94% ($56.0 million in
2004 vs. $108.4 million in 2014) (not shown), and local government revenue increased by
14% ($70.2 million in 2004 vs. $80.4 million in 2014) (not shown). The increase
($166.5 million) in revenue from these three sources was too low to offset the $308.0 million
in losses from Title X, client service fees, block grants, and state government. For each of
these sources, the decline was as follows:

▪ Title X revenue decreased 30%, or by $104.5 million, from 2004 ($353.9 million) to
2014 ($249.5 million) (Exhibit A–12a).

▪ Client service fee revenue decreased 62%, or by $86.9 million, from 2004
($140.1 million) to 2014 ($53.2 million) (not shown).

▪ Block grant revenue decreased 68%, or by $60.9 million, from 2004 ($89.6 million) to
2014 ($28.7 million) (not shown).

▪ State government revenue decreased 32%, or by $55.7 million, from 2004
($176.7 million) to 2014 ($121.0 million) (not shown).

Exhibit A–12a to A–12e present trends (2004 to 2014) in actual and inflation-adjusted total,
Title X, and Medicaid (including CHIP) revenue.
Since 2004, there have been some noteworthy changes in the composition of Title X program
revenue. From 2004 to 2014, Medicaid revenue (includes CHIP revenue after 2004) increased
from 28% of total revenue to 40%, Title X revenue decreased from 26% to 20%, state and
local government revenue decreased from 18% to 16%, and revenue from all other sources
decreased from 28% to 24% (Exhibits A-13a through A-13c).
Family Planning Annual Report: 2014 National Summary

57

Exhibit 32. Amount of Title X project revenues, by revenue source and region: 2014 (Source: FPAR Table 14)

58

All Regions
($)

Revenue Source
Title X
Payment for Services
Client fees
Third-party payers
Medicaid b

Region I
($)

Region II
($)

Region III
($)

Region IV
($)

Region V
($)

Region VI
($)

Region VII
($)

Region VIII
($)

Region IX
($)

Region X
($)

249,517,445

13,310,967

28,391,674

25,721,998

52,372,338

35,812,377

28,946,492

13,660,766

10,264,499

31,841,098

9,195,236

53,170,034

2,940,592

10,870,359

5,263,678

6,772,878

6,938,196

1,959,533

3,328,318

4,042,395

7,483,260

3,570,825

490,470,842

12,960,617

53,774,118

33,486,099

69,879,226

36,776,894

12,537,245

7,568,391

3,590,959

236,509,259

23,388,034

3,083,719

261,771

465,864

970,856

430,222

439,611

47,985

70,266

30,600

279,258

87,286

a

Medicare
CHIP

2,590,621

2,357

12,090

48,622

169,268

2,194,727

124,592

9,001

29,964

0

0

Other public c

10,202,966

1,197,295

45,824

730,000

1,843

236,929

7,594,707

85,623

70,071

236,594

4,080

Private

95,138,355

9,943,265

14,389,419

13,666,019

6,426,907

18,364,233

5,667,449

6,844,067

4,216,996

8,519,079

7,100,921

Subtotal

654,656,537

27,305,897

79,557,674

54,165,274

83,680,344

64,950,590

27,931,511

17,905,666

11,980,985

253,027,450

34,151,146

Family Planning Annual Report: 2014 National Summary

Other Revenue
MCH block grant

23,095,828

36,000

6,356,491

3,152,485

4,363,814

3,608,516

2,023,636

335,687

286,890

1,342,274

1,590,035

SS block grant

5,601,590

1,063,759

0

2,544,711

0

1,857,006

0

0

22,280

113,834

0

TANF

10,570,729

238,369

0

0

8,605,054

1,679,139

0

0

48,167

0

0

State government

120,974,720

5,698,088

38,954,953

21,028,964

27,553,654

3,279,495

10,439,523

259,314

735,799

1,652,463

11,372,467

Local government

80,388,864

67,431

10,878,609

7,050,099

34,625,951

6,516,860

979,268

612,811

8,550,562

3,356,227

7,751,046

BPHC

10,080,722

122,793

1,227,325

0

490,497

4,506,744

156,832

132,254

0

3,066,400

377,877

Other d
Subtotal
Total Revenue

89,015,512

2,067,092

6,064,547

1,928,643

4,778,662

11,944,327

3,570,071

1,420,619

5,169,859

50,731,818

1,339,874

339,727,965

9,293,532

63,481,925

35,704,902

80,417,632

33,392,087

17,169,330

2,760,685

14,813,557

60,263,016

22,431,299

1,243,901,947

49,910,396

171,431,273

115,592,174

216,470,314

134,155,054

74,047,333

34,327,117

37,059,041

345,131,564

65,777,681

Total Revenue 2004

e

886,133,687

35,555,281

122,124,599

82,345,815

154,209,613

95,569,681

52,750,007

24,454,029

26,400,204

245,865,605

46,858,853

Total Revenue 1981

e

236,892,882

9,505,104

32,647,950

22,013,763

41,225,337

25,548,941

14,101,824

6,537,372

7,057,649

65,728,019

12,526,923

301

271

399

247

281

355

248

231

270

300

397

Total Revenue per User

BPHC=Bureau of Primary Health Care. CHIP=Children’s Health Insurance Program. MCH=Maternal and Child Health. SS=Social Services. TANF=Temporary Assistance for Needy Families.
Note: Unless otherwise noted, revenue is shown in actual dollars (unadjusted) for each year.
a
b

c
d
e

Prepaid and not prepaid.
Includes revenue from Medicaid family planning eligibility expansions in 29 states in all 10 HHS regions. See Table 14 comments in the Field and Methodological Notes (Appendix C) for a
list of states by region.
“All Regions” and “Region VI” amounts for “Other Public” third-party payment for services include revenue from the Texas Women’s Health Program.
See Table 14 comments in the Field and Methodological Notes (Appendix C) for a list of the types of revenue reported as “other.”
Revenue is shown in constant 2004 dollars (2004$) or 1981 dollars (1981$), based on the consumer price index for medical care, which includes medical care commodities and medical care
services (Source: U.S. Department of Labor, Bureau of Labor Statistics, Series ID. CUUR0000SAM, http://data.bls.gov/cgi-bin/srgate).

Family Planning Annual Report: 2014 National Summary

Exhibit 33. Distribution of Title X project revenues, by revenue source and region: 2014 (Source: FPAR Table 14)
Revenue Source

All Regions

Title X
Payment for Services
Client fees
Third-party payers
Medicaid b

Region I

Region II

Region III

Region IV

Region V

Region VI

Region VII

Region VIII

Region IX

Region X

20%

27%

17%

22%

24%

27%

39%

40%

28%

9%

14%

4%

6%

6%

5%

3%

5%

3%

10%

11%

2%

5%

39%

26%

31%

29%

32%

27%

17%

22%

10%

69%

36%

a

Medicare

0%†

1%

0%†

1%

0%†

0%†

0%†

0%†

0%†

0%†

CHIP

0%†

0%†

0%†

0%†

0%†

2%

0%†

0%†

0%†

0%

0%

Other public c

1%

2%

0%†

1%

0%†

0%†

0%†

0%†

0%†

0%†

Private

8%

20%

8%

12%

3%

14%

8%

20%

11%

2%

11%

Subtotal

53%

55%

46%

47%

39%

48%

38%

52%

32%

73%

52%

10%

0%†

Other Revenue
MCH block grant

2%

0%†

4%

3%

2%

3%

3%

1%

1%

0%†

2%

SS block grant

0%†

2%

0%

2%

0%

1%

0%

0%

0%†

0%†

0%

TANF

1%

0%†

0%

0%

4%

1%

0%

0%

0%†

0%

0%

23%

18%

13%

2%

14%

1%

2%

0%†

17%

6%

6%

16%

5%

1%

2%

23%

1%

12%

State government

10%

Local government

6%

11%
0%†

BPHC

1%

0%†

1%

0%

0%†

3%

0%†

0%†

0%

1%

1%

Other d

7%

4%

4%

2%

2%

9%

5%

4%

14%

15%

2%

Subtotal

27%

19%

37%

31%

37%

25%

23%

8%

40%

17%

34%

Total Revenue

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

BPHC=Bureau of Primary Health Care. CHIP=Children’s Health Insurance Program. MCH=Maternal and Child Health. SS=Social Services. TANF=Temporary Assistance for Needy
Families.
Note: Due to rounding, percentages may not sum to 100%.
a
Prepaid and not prepaid.
b
Includes revenue from Medicaid family planning eligibility expansions in 29 states in all 10 HHS regions. See Table 14 comments in the Field and Methodological Notes
(Appendix C) for a list of states by region.
c
“All Regions” and “Region VI” percentages for “Other Public” third-party payment for services include revenue from the Texas Women’s Health Program.
d
See Table 14 comments in the Field and Methodological Notes (Appendix C) for a list of the types of revenue reported as “other.”
† Percentage is less than 0.5%.

59

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60

Family Planning Annual Report: 2014 National Summary

4

References
1. Office of Population Affairs. (2014) Program requirements for Title X funded
family planning projects (Version 1.0). Retrieved from
http://www.hhs.gov/opa/pdfs/ogc-cleared-final-april.pdf
2. 42 Code of Federal Regulations (CFR) Part 59 Subpart A. Project grants for
family planning services. Retrieved from http://www.hhs.gov/opa/pdfs/42-cfr59-b.pdf
3. Frost, J. J. (2013, May). U.S. women’s use of sexual and reproductive health
services: Trends, sources of care and factors associated with use, 1995–2010.
New York: Guttmacher Institute. Retrieved from
http://www.guttmacher.org/pubs/sources-of-care-2013.pdf
4. Office of Population Affairs. Title X funding history. Retrieved from
http://www.hhs.gov/opa/about-opa-and-initiatives/funding-history/
5. Office of Population Affairs. (2013). Family planning annual report: Forms
and instructions (Reissued October 2013). Rockville, MD: U.S. Department of
Health and Human Services, Office of the Assistant Secretary for
Health/Office, Office of Population Affairs. Retrieved from
http://www.hhs.gov/opa/pdfs/fpar-reissued-oct13.pdf
6. 45 CFR Part 74. Uniform administrative requirements for awards and
subawards to institutions of higher education, hospitals, other nonprofit
organizations, and commercial organizations; and certain grants and
agreements with states, local governments, and Indian tribal governments.
Retrieved from http://www.hhs.gov/opa/grants-and-funding/grant-forms-andreferences/45-cfr-74.html
7. 45 CFR Part 92. Uniform administrative requirements for grants and
cooperative agreements to state and local governments. Retrieved from
http://www.hhs.gov/opa/grants-and-funding/grant-forms-and-references/45cfr-92.html
8. U.S. Department of Health and Human Services. (2014). The 2014 HHS
poverty guidelines. Retrieved from http://aspe.hhs.gov/poverty/14poverty.cfm
9. Office of Management and Budget. (1997). Revisions to the standards for the
classification of federal data on race and ethnicity, October 30, 1997. Federal
Register Notice. Retrieved from
http://www.whitehouse.gov/omb/fedreg_1997standards

Family Planning Annual Report: 2014 National Summary

61

10. We group primary contraceptive methods into three categories—highly,
moderately, and less effective—based on the effectiveness of each method in
preventing pregnancy under typical use conditions. These categories
correspond to the three groups or tiers defined by Trussell (2011) (see
http://www.contraceptivetechnology.org/the-book/take-a-peek/contraceptiveefficacy/).
Highly effective contraceptives refer to methods that result in less than 1% of
women experiencing an unintended pregnancy during the first year of typical
use. They include:






Male sterilization/vasectomy, 0.15%
Female sterilization, 0.5%
Implant (Implanon), 0.05%
Intrauterine device (Mirena), 0.2%
Intrauterine device (ParaGard), 0.8%

Moderately effective contraceptives refer to methods that result in between 6%
and 12% of women experiencing an unintended pregnancy during the first year
of typical use. They include:






Injectable (Depo-Provera), 6%
Vaginal ring (NuvaRing), 9%
Contraceptive patch (Evra), 9%
Combined and progestin-only pills, 9%
Diaphragm (with spermicidal cream/jelly), 12%

Less-effective contraceptives refer to methods that result in between 18% and
28% of women experiencing an unintended pregnancy during the first year of
typical use. They include:








Male condom, 18%
Female condom, 21%
Sponge, Nulliparous women, 12%
Sponge, Parous women, 24%
Withdrawal, 22%
Fertility awareness-based method, 24%
Spermicides, 28%

Because the FPAR combines some methods into a single reporting category
(e.g., FAM or LAM, diaphragm or cervical cap), the methods in two of the
three effectiveness categories may differ slightly from those listed above. We
do not expect these differences to have an impact on the findings because so
few users rely on the methods in these combined categories. (Source: Trussell,
J. [2011]. Chapter 26: Contraceptive: efficacy. In R. A. Hatcher, J. Trussell, A.
L. Nelson, W. Cates, D. Kowal, & M. S. Policar (Eds.), Contraceptive
technology (20th ed.). New York, NY: Ardent Media, Inc.).
11. Title X of the Public Health Service Act, 42 U.S. Code 300 et seq.
http://www.hhs.gov/opa/pdfs/title-x-statute-attachment-a.pdf
62

Family Planning Annual Report: 2014 National Summary

12. U.S. Department of Health and Human Services, Office of the Assistant
Secretary for Planning and Evaluation, (2010). Poverty guidelines, research,
and measurement. Retrieved from http://aspe.hhs.gov/poverty/index.shtml
13. U.S. Department of Health and Human Services. (2003, August 8). Guidance
to federal financial assistance recipients regarding Title VI prohibition against
national origin discrimination affecting limited English proficient persons
(“Revised HHS LEP guidance”). Federal Register, 68(153), 47311–47323.
Retrieved from
http://www.hhs.gov/ocr/civilrights/resources/specialtopics/lep/policyguidance
document.html
14. Kennedy, K. I., & Trussell, J. (2011). Postpartum contraception and lactation.
In R. A. Hatcher, J. Trussell, A. L. Nelson, W. Cates, D. Kowal, & M. S.
Policar (Eds.), Contraceptive technology (20th ed., pp. 483–511). New York,
NY: Ardent Media.
15. U.S. Centers for Disease Control & Prevention and the U.S. Office of
Population Affairs. (2014, April). Providing quality family planning services:
Recommendations of CDC and the U.S. Office of Population Affairs. MMWR,
63(4), 1–54.
16. Solomon, D., Davey, D., Kurman, R., Moriarty, A., O’Connor, D., Prey, M.,
Raab, S., Sherman, M., Wilbur, D., Wright, Jr., T., & Young, N. (2002). The
2001 Bethesda System: Terminology for reporting results of cervical cytology.
Journal of the American Medical Association, 287(16), 2114–2119. Retrieved
from http://jama.jamanetwork.com/article.aspx?volume=287&page=2114
17. Apgar, B. S., Zoschnick, L., & Wright, T. C. (2003). The 2001 Bethesda
System terminology. American Academy of Family Physicians, 2003(68),
1992–1998. Retrieved from http://www.aafp.org/afp/2003/1115/p1992.pdf
18. Wright, T. C., Cox, J. T., Massad, L. S., Twiggs, L. B., & Wilkinson, E. J.
(2002). 2001 consensus guidelines for the management of women with
cervical cytological abnormalities. Journal of the American Medical
Association, 287(16), 2120–2129. Retrieved from
http://jama.jamanetwork.com/article.aspx?articleid=194862. For updated
consensus guidelines for managing women with abnormal tests, see Wright, T.
C., Massad, L. S., Dunton, C. J., Spitzer, M., Wilkinson, E. J., & Solomon, D.
(2007, October). 2006 consensus guidelines for the management of women
with abnormal cervical cancer screening tests. American Journal of Obstetrics
& Gynecology, 197(4), 337–339. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0002937807009301
19. Centers for Disease Control and Prevention. (2014). Sexually transmitted
disease surveillance 2013. Atlanta, GA: U.S. Department of Health and
Human Services. Retrieved from http://www.cdc.gov/std/stats13/surv2013print.pdf
Family Planning Annual Report: 2014 National Summary

63

20. Centers for Disease Control and Prevention. (2015). Sexually transmitted
diseases treatment guidelines, 2015. MMWR, 64(RR-3), 1–137. Retrieved from
http://www.cdc.gov/std/tg2015/tg-2015-print.pdf
21. Centers for Disease Control and Prevention. (2006). Revised recommendations
for HIV testing of adults, adolescents, and pregnant women in health-care
settings. MMWR, 55(No. RR-14), 1–17. Retrieved from
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm.
22. U.S. Preventive Services Task Force. (2014, September). Gonorrhea and
chlamydia: Screening. Retrieved from
http://www.uspreventiveservicestaskforce.org/Page/Document/Recommendati
onStatementFinal/chlamydia-and-gonorrhea-screening
23. U.S. Department of Labor, Bureau of Labor Statistics (BLS). Consumer price
index: Series ID. CUUR0000SAM. Retrieved from http://data.bls.gov/cgibin/srgate

64

Family Planning Annual Report: 2014 National Summary

Appendix A
National Trend Exhibits

A-2

Exhibit A–1a.
Region

Number and distribution of all family planning users, by region and year: 2004–2014
2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

I

207,450

211,693

212,169

199,010

197,165

199,779

198,962

192,252

195,264

182,684

184,005

II

468,635

468,237

470,148

479,572

483,928

497,614

499,231

493,369

488,872

470,836

429,409

III

571,883

562,173

567,583

557,031

564,138

592,475

584,167

564,163

550,051

520,403

468,157

IV

1,052,584

1,051,887

1,051,330

1,018,656

1,019,264

1,010,012

989,770

940,931

907,020

852,400

770,501

V

610,058

600,145

582,313

531,679

507,431

492,741

492,359

472,062

434,587

401,935

377,552

VI

547,802

513,130

483,632

486,378

491,406

512,019

512,868

475,863

350,164

372,296

298,294

VII

257,833

243,299

245,133

234,592

210,012

209,350

214,032

205,167

186,716

167,286

148,405

VIII

154,924

157,150

156,482

149,395

151,261

160,919

176,892

169,311

163,068

152,248

137,509

IX

920,543

931,827

973,524

1,102,718

1,209,114

1,294,974

1,352,569

1,314,270

1,309,439

1,269,252

1,149,781

X

276,073

263,420

251,964

228,207

217,786

216,384

204,012

194,323

178,616

168,484

165,670

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

4,823,404

4,740,168

4,721,869

4,691,857

4,723,662

4,811,691

4,822,570

4,635,195

4,378,744

4,184,587

3,764,622

244,381

262,793

272,409

295,381

327,843

374,576

402,292

386,516

385,053

373,237

364,661

I

4%

4%

4%

4%

4%

4%

4%

4%

4%

4%

4%

II

9%

9%

9%

10%

10%

10%

10%

10%

10%

10%

10%

III

11%

11%

11%

11%

11%

11%

11%

11%

12%

11%

11%

IV

21%

21%

21%

20%

20%

19%

19%

19%

19%

19%

19%

V

12%

12%

12%

11%

10%

10%

9%

9%

9%

9%

9%

VI

11%

10%

10%

10%

10%

10%

10%

9%

7%

8%

7%

VII

5%

5%

5%

5%

4%

4%

4%

4%

4%

4%

4%

VIII

3%

3%

3%

3%

3%

3%

3%

3%

3%

3%

3%

IX

18%

19%

19%

22%

24%

25%

26%

26%

27%

28%

28%

X

5%

5%

5%

5%

4%

4%

4%

4%

4%

4%

4%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

95%

95%

95%

94%

94%

93%

92%

92%

92%

92%

91%

5%

5%

5%

6%

6%

7%

8%

8%

8%

8%

9%

Total

Family Planning Annual Report: 2014 National Summary

Female
Male

Total
Female
Male

Note: Due to rounding, percentages may not sum to 100%.

Family Planning Annual Report: 2014 National Summary

Exhibit A–1b.

Number and distribution of all family planning users, by region and year: 2004–2014

2014

4%

10%

11%

19%

9%

7%

4% 3%

28%

4%

2013

4%

10%

11%

19%

9%

8%

4% 3%

28%

4% 4.56 million

2012

4%

10%

12%

19%

7%

4% 3%

27%

4% 4.76 million

2011

4%

10%

11%

19%

9%

9%

4% 3%

26%

4%

5.02 million

2010

4%

10%

11%

19%

9%

10%

4% 3%

26%

4%

5.22 million

2009

4%

10%

11%

19%

25%

4% 5.19 million

2008

4%

10%

11%

20%

24%

4%

5.05 million

2007

4%

10%

11%

20%

5%

4.99 million

2006

4%

9%

11%

21%

12%

10%

19%

5%

4.99 million

2005

4%

9%

11%

21%

12%

10%

5% 3%

19%

5%

5.00 million

2004

4%

9%

11%

21%

12%

11%

5% 3%

18%

5%

5.07 million

9%

10%

10%

10%

4% 3%

10%

11%

4% 3%

10%

5% 3%
5% 3%

22%

0%

4.13 million

100%

I

II

III

IV

Note: Due to rounding, percentages may not sum to 100%.

V

VI

VII

VIII

IX

X

A-3

A-4

Exhibit A–2a.

Number and distribution of all family planning users, by age and year: 2004–2014

Age Group (Years)

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Family Planning Annual Report: 2014 National Summary

Under 15

—

70,840

67,627

68,918

71,738

74,287

73,383

59,351

53,012

45,633

45,863

Under 18

667,734

––

––

––

––

––

––

––

––

––

––

15 to 17

—

549,079

549,844

534,054

521,202

502,226

466,284

423,702

368,965

327,152

298,839

18 to 19

716,399

681,690

672,027

651,784

652,059

647,432

616,709

560,848

505,356

454,044

404,197

20 to 24

1,608,278

1,589,794

1,582,688

1,556,670

1,553,469

1,577,051

1,600,833

1,508,215

1,405,487

1,320,188

1,169,948

25 to 29

898,231

921,425

943,009

967,409

996,754

1,037,776

1,071,999

1,058,256

1,023,503

999,476

912,130

30 to 44

1,028,661

––

––

––

––

––

––

––

––

––

––

30 to 34

—

519,448

512,173

522,673

539,998

578,031

607,257

621,119

616,259

622,258

573,010

35 to 39

—

317,900

314,488

323,885

332,854

353,712

359,749

358,400

351,820

355,877

331,439

40 to 44

—

193,490

188,507

191,503

195,582

209,292

215,914

222,429

222,621

220,836

200,955

Over 44

148,482

159,295

163,915

170,342

187,849

206,460

212,734

209,391

216,774

212,360

192,902

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

Under 15

—

1%

1%

1%

1%

1%

1%

1%

1%

1%

1%

Under 18

13%

––

––

––

––

––

––

––

––

––

––

15 to 17

—

11%

11%

11%

10%

10%

9%

8%

8%

7%

7%

18 to 19

14%

14%

13%

13%

13%

12%

12%

11%

11%

10%

10%

20 to 24

32%

32%

32%

31%

31%

30%

31%

30%

30%

29%

28%

25 to 29

18%

18%

19%

19%

20%

20%

21%

21%

21%

22%

22%

30 to 44

20%

––

––

––

––

––

––

––

––

––

––

30 to 34

—

10%

10%

10%

11%

11%

12%

12%

13%

14%

14%

35 to 39

—

6%

6%

6%

7%

7%

7%

7%

7%

8%

8%

40 to 44

—

4%

4%

4%

4%

4%

4%

4%

5%

5%

5%

Over 44

3%

3%

3%

3%

4%

4%

4%

4%

5%

5%

5%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Total

Total

Note: Due to rounding, percentages may not sum to 100%.
— Disaggregated data are not available.
– – Disaggregated data are presented in the table.

Family Planning Annual Report: 2014 National Summary

Exhibit A–2b.

2014

Number and distribution of all family planning users, by age and year: 2004–2014

< 18, 8% 18–19, 10%
10%

20–24, 28%

25–29, 22%

30–44, 27%

5%

4.13 million

29%

22%

26%

5%

4.56 million

5%

4.76 million

2013

8%

2012

9%

2011

10%

2010

10%

2009

11%

2008

12%

13%

2007

12%

13%

2006

12%

13%

32%

2005

12%

14%

32%

2004

13%

11%

30%

11%

21%

30%

12%

21%

31%

20%

31%

23%

4% 5.22 million

22%

4% 5.19 million
4% 5.05 million

21%

3% 4.99 million

19%

20%

3% 4.99 million

18%

21%

3% 5.00 million

20%

3% 5.07 million

19%

18%

32%

4% 5.02 million

21%

20%

31%

14%

24%

21%

30%

12%

25%

0%

100%

< 18

18–19

20–24

25–29

30–44

> 44

Note: Due to rounding, percentages in each year may not sum to 100%, and percentages in combined or aggregated categories may not match the sum of the individual percentages
that are included in the aggregated categories.

A-5

A-6

Exhibit A–3a.

Number and distribution of all family planning users, by race and year: 2004–2014

Race

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

American Indian/Alaska Native

36,050

35,665

38,098

38,080

36,974

39,220

44,899

43,204

45,785

34,051

29,327

136,813

124,946

129,155

131,735

137,747

150,847

136,958

134,345

136,412

135,567

128,797

1,027,880

969,301

953,580

958,241

996,093

1,015,013

1,028,991

986,803

969,776

939,941

863,136

58,881

58,946

44,708

43,360

45,693

73,559

65,662

70,929

70,519

52,263

39,266

3,225,150

3,183,116

3,239,675

3,125,435

3,007,568

3,054,226

3,015,861

2,864,253

2,664,736

2,530,204

2,238,847

—

127,543

122,583

132,911

151,535

169,044

261,397

250,825

248,590

191,871

153,907

583,011

503,444

466,479

557,476

675,895

684,358

671,094

671,352

627,979

673,927

676,003

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

American Indian/Alaska Native

1%

1%

1%

1%

1%

1%

1%

1%

1%

1%

1%

Asian

3%

2%

3%

3%

3%

3%

3%

3%

3%

3%

3%

20%

19%

19%

19%

20%

20%

20%

20%

20%

21%

21%

1%

1%

1%

1%

1%

1%

1%

1%

1%

1%

1%

64%

64%

65%

63%

60%

59%

58%

57%

56%

56%

54%

—

3%

2%

3%

3%

3%

5%

5%

5%

4%

4%

12%

10%

9%

11%

13%

13%

13%

13%

13%

15%

16%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Asian
Black/African American
Native Hawaiian/Pacific Islander
White
More than one race
Unknown/not reported
Total All Users

Family Planning Annual Report: 2014 National Summary

Black/African American
Native Hawaiian/Pacific Islander
White
More than one race
Unknown/not reported
Total All Users

Note: Due to rounding, percentages may not sum to 100%.
— Data are not available.

Family Planning Annual Report: 2014 National Summary

Exhibit A–3b.

Number and distribution of all family planning users, by race and year: 2004–2014

White, 54%

2014

Black, 21%

Other, 9%

Unknown, 16%

2013

56%

21%

9%

2012

56%

20%

11%

13%

4.76 million

2011

57%

10%

13%

5.02 million

2010

58%

10%

13%

5.22 million

8%

13%

5.19 million

7%

13%

5.05 million

20%
20%

2009

59%

2008

60%

20%
20%

63%

2007

19%

65%

2006

19%

15%

4.13 million

7%
7%

2005

64%

19%

7%

2004

64%

20%

5%

0%

4.56 million

11%

4.99 million

9%

4.99 million

10%

5.00 million

12%

5.07 million
100%

White

Black

Other

Unknown

Note: Due to rounding, percentages in each year may not sum to 100%, and percentages in combined or aggregated categories may not match the sum of the individual percentages
that are included in the aggregated categories. The Other race category includes users who self-identified as American Indian or Alaska Native, Asian, Native Hawaiian or Other
Pacific Islander (2004–2014), and more than one race (2005–2014).

A-7

A-8

Exhibit A–4a.

Number and distribution of all family planning users, by Hispanic or Latino ethnicity (all races) and year: 2004–2014

Ethnicity

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Hispanic or Latino

1,159,637

1,181,093

1,223,732

1,303,402

1,391,523

1,447,422

1,493,007

1,451,215

1,349,528

1,344,601

1,237,652

Not Hispanic or Latino

3,780,396

3,628,142

3,670,894

3,611,497

3,534,915

3,618,344

3,618,285

3,416,314

3,277,828

3,093,545

2,786,005

Unknown/not reported

127,752

193,726

99,652

72,339

125,067

120,501

113,570

154,182

136,441

119,678

105,626

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

Hispanic or Latino

23%

24%

25%

26%

28%

28%

29%

29%

28%

30%

30%

Not Hispanic or Latino

75%

73%

74%

72%

70%

70%

69%

68%

69%

68%

67%

Unknown/not reported

3%

4%

2%

1%

2%

2%

2%

3%

3%

3%

3%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Total All Users

Total All Users

Family Planning Annual Report: 2014 National Summary

Note: Due to rounding, percentages may not sum to 100%.

Family Planning Annual Report: 2014 National Summary

Exhibit A–4b.

Number and distribution of all family planning users, by Hispanic or Latino ethnicity (all races) and year: 2004–2014

2014

Not Hispanic/Latino, 67%

Hispanic/Latino, 30%

4.13 million

2013

68%

30%

4.56 million

2012

69%

28%

4.76 million

2011

68%

29%

5.02 million

2010

69%

29%

5.22 million

2009

70%

28%

5.19 million

2008

70%

28%

5.05 million

2007

72%

26%

4.99 million

2006

74%

25%

4.99 million

2005

73%

24%

75%

2004

23%

0%

5.00 million
5.07 million
100%

Not Hispanic/Latino
Note: Due to rounding, percentages may not sum to 100%.

Hispanic/Latino

Unknown

A-9

A-10

Exhibit A–5a.

Number and distribution of all family planning users, by Hispanic or Latino ethnicity, race, and year: 2004–2014

Ethnicity and Race

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Not Hispanic or Latino
All races

3,780,396

––

––

––

––

––

––

––

––

––

––

Asian

—

118,499

123,192

126,320

127,850

139,831

126,413

121,777

124,790

128,015

119,454

Black or African
American

—

929,066

918,983

926,564

956,741

969,690

986,409

939,143

917,539

890,133

816,061

White

—

2,366,762

2,400,897

2,324,430

2,232,893

2,227,867

2,214,680

2,060,244

1,951,410

1,812,924

1,583,629

Other/unknown

—

213,815

227,822

234,183

217,431

280,956

290,783

295,150

284,089

262,473

266,861

1,159,637

1,181,093

1,223,732

1,303,402

1,391,523

1,447,422

1,493,007

1,451,215

1,349,528

1,344,601

1,237,652

127,752

193,726

99,652

72,339

125,067

120,501

113,570

154,182

136,441

119,678

105,626

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

75%

––

––

––

––

––

––

––

––

––

––

Asian

—

2%

2%

3%

3%

3%

2%

2%

3%

3%

3%

Black or African
American

—

19%

18%

19%

19%

19%

19%

19%

19%

20%

20%

White

—

47%

48%

47%

44%

43%

42%

41%

41%

40%

38%

Other/unknown

—

4%

5%

5%

4%

5%

6%

6%

6%

6%

6%

23%

24%

25%

26%

28%

28%

29%

29%

28%

30%

30%

3%

4%

2%

1%

2%

2%

2%

3%

3%

3%

3%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Hispanic or Latino
All races
Unknown/not reported

Family Planning Annual Report: 2014 National Summary

Total All Users
Not Hispanic or Latino
All races

Hispanic or Latino
All races
Unknown/not reported
Total All Users

Note: The Other race category includes users who self-identified as American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander (2004–2014), and more than one race
(2005–2014). Due to rounding, percentages may not sum to 100%.
— Disaggregated data are not available.
– – Disaggregated data are presented in the table.

Family Planning Annual Report: 2014 National Summary

Exhibit A–5b.

Number and distribution of all family planning users, by Hispanic or Latino ethnicity, race, and year: 2004–2014

NH White, 38%

2014

40%

2013

NH Other,
9%

NH Black, 20%
20%

9%

2012

41%

19%

2011

41%

19%

9%
8%

Hispanic (all races), 30%

4.13 million

30%

4.56 million

28%

4.76 million

29%

5.02 million

2010

42%

19%

8%

29%

5.22 million

2009

43%

19%

8%

28%

5.19 million

28%

5.05 million

44%

2008

19%

47%

2007
2006

48%

2005

47%

7%

19%
18%
19%
NH (all races), 75%

2004

7%
7%
7%

26%

4.99 million

25%

4.99 million

24%

5.00 million

23%

0%

5.07 million
100%

NH (all races)

NH White

NH Black

NH Other

Hispanic (all races)

Unknown

NH=Not Hispanic or Latino.
Note: Due to rounding, percentages in each year may not sum to 100%, and percentages in combined or aggregated categories may not match the sum of the individual percentages
that are included in the aggregated categories. The “NH Other” category (2005–2014) includes users who self-identified as not Hispanic or Latino and for whom either race was
unknown/not reported or the user self-identified as one of the following: Asian, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, or more than one race.
The “Unknown” category includes users with unknown or not reported Hispanic or Latino ethnicity.

A-11

A-12

Exhibit A–6a.

Number and distribution of all family planning users, by income level and year: 2004–2014

Income Level a

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

3,461,649

3,316,699

3,353,129

3,455,335

3,553,222

3,632,506

3,618,813

3,466,912

3,382,089

3,211,380

2,840,650

101% to 150%

838,704

879,666

846,873

820,870

781,113

785,090

795,065

731,410

649,462

636,484

572,948

151% to 200%

312,393

324,358

311,958

303,992

278,881

277,103

281,294

269,478

247,490

245,805

234,425

Over 200%

355,025

––

––

––

––

––

––

––

––

––

––

201% to 250%

—

129,097

127,902

121,473

119,181

119,768

125,298

116,188

103,061

103,246

100,402

Over 250%

—

242,241

262,501

212,849

224,603

207,484

250,440

250,829

230,947

222,718

226,918

100,014

110,900

91,915

72,719

94,505

164,316

153,952

186,894

150,748

138,191

153,940

5,067,785

5,002,961

4,994,278

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,129,283

Under 101%

68%

66%

67%

69%

70%

70%

69%

69%

71%

70%

69%

101% to 150%

17%

18%

17%

16%

15%

15%

15%

15%

14%

14%

14%

151% to 200%

6%

6%

6%

6%

6%

5%

5%

5%

5%

5%

6%

Over 200%

7%

––

––

––

––

––

––

––

––

––

––

201% to 250%

—

3%

3%

2%

2%

2%

2%

2%

2%

2%

2%

Over 250%

—

5%

5%

4%

4%

4%

5%

5%

5%

5%

5%

2%

2%

2%

1%

2%

3%

3%

4%

3%

3%

4%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Under 101%

Unknown/not reported
Total All Users

Family Planning Annual Report: 2014 National Summary

Unknown/not reported
Total All Users

Note: Due to rounding, percentages may not sum to 100%.
a

Title X-funded agencies report user income as a percentage of poverty based on guidelines issued by the U.S. Department of Health and Human Services (HHS). Each year,
HHS announces updates to its poverty guidelines in the Federal Register and on the HHS Website at http://aspe.hhs.gov/poverty/.

— Disaggregated data are not available.
– – Disaggregated data are presented in the table.

Family Planning Annual Report: 2014 National Summary

Exhibit A–6b.

Number and distribution of all family planning users, by income level and year: 2004–2014

≤ 100%, 69%

2014

101%–150%, 14%

6%

8%

4.13 million

2013

70%

14%

5%

7%

4.56 million

2012

71%

14%

5%

7%

4.76 million

2011

69%

15%

5%

7%

2010

69%

15%

2009

70%

15%

2008

70%

15%

6%

7%

5.05 million

2007

69%

16%

6%

7%

4.99 million

5%
5%

5.02 million

7%

5.22 million

6%

5.19 million

2006

67%

17%

6%

8%

4.99 million

2005

66%

18%

6%

7%

5.00 million

7%

5.07 million

68%

2004

17%

6%

0%

100%

≤ 100%

101%–150%

151%–200%

> 200%

Unknown

Note: Title X-funded agencies report user income as a percentage of poverty based on guidelines issued by the U.S. Department of Health and Human Services (HHS). Each year,
HHS announces updates to its poverty guidelines in the Federal Register and on the HHS Website at http://aspe.hhs.gov/poverty/. Due to rounding, percentages in each year
may not sum to 100%, and percentages in combined or aggregated categories may not match the sum of the individual percentages that are included in the aggregated
categories.

A-13

A-14

Exhibit A–7a.

Number and distribution of all family planning users, by health insurance status and year: 2005–2014

Insurance Status

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Insured

1,439,943

1,394,225

1,470,034

1,524,906

1,447,472

1,622,837

1,666,262

1,568,713

1,584,941

1,775,368

Uninsured

3,053,824

2,998,508

3,202,642

3,305,185

3,419,915

3,483,360

3,230,784

3,050,415

2,865,672

2,237,098

Unknown/not reported

500,511

610,228

314,562

221,414

318,880

118,665

124,665

144,669

107,211

114,453

4,994,278

5,002,961

4,987,238

5,051,505

5,186,267

5,224,862

5,021,711

4,763,797

4,557,824

4,126,919

Insured

29%

28%

29%

30%

28%

31%

33%

33%

35%

43%

Uninsured

61%

60%

64%

65%

66%

67%

64%

64%

63%

54%

Total

Unknown/not reported
Total

10%

12%

6%

4%

6%

2%

2%

3%

2%

3%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

Note: Due to rounding, percentages may not sum to 100%.

Family Planning Annual Report: 2014 National Summary

Family Planning Annual Report: 2014 National Summary

Exhibit A–7b.

Number and distribution of all family planning users, by health insurance status and year: 2005–2014

Insured, 43%

2014

Uninsured, 54%

4.13 million

63%

4.56 million

35%

2013
2012

33%

64%

4.76 million

2011

33%

64%

5.02 million

31%

2010

67%

5.22 million
5.19 million

28%

2009

66%
5.05 million

30%

2008

65%

29%

2007

64%

4.99 million
4.99 million

2006

28%

60%

5.00 million

2005

29%

61%

5.07 million

0%

100%

Insured
Note: Due to rounding, percentages may not sum to 100%.

Uninsured

Unknown/Not reported

A-15

A-16

Exhibit A–8a.
Primary Method

Number of female family planning users, by primary contraceptive method and year: 2004–2014
2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Family Planning Annual Report: 2014 National Summary

Highly Effective a
—
7,060
6,605
6,546
6,312
6,905
8,683
8,632
8,540
8,175
7,582
Vasectomy b
105,103
95,264
89,428
89,447
87,167
92,616
92,652
90,438
86,854
82,067
Sterilization b
74,748
5,602
3,395
2,506
7,300
18,738
30,135
48,015
65,673
82,642
108,586
Hormonal implant
139,799
77,773
88,342
110,338
138,714
179,876
216,390
252,121
272,683
284,461
279,289
Intrauterine device
265,511
Moderately Effective a
Hormonal injection c
740,028
602,721
571,588
591,861
597,572
615,188
643,682
645,351
645,136
635,093
611,619
—
65,320
98,689
139,656
149,627
165,121
186,238
183,182
164,693
142,292
Vaginal ring d
115,230
—
286,214
170,815
128,324
101,763
106,266
93,499
89,795
83,145
78,547
Contraceptive patch d
69,469
1,974,050
1,852,654
1,859,542
1,826,518
1,734,786
1,696,319
1,684,201
1,534,684
1,409,300
1,316,671
Oral contraceptive
1,135,950
11,717
5,477
4,753
4,087
3,612
12,278
4,402
3,390
4,116
8,245
Cervical cap/diaphragm
2,379
Less Effective a
Male condom
737,169
686,992
747,323
716,646
727,440
737,991
787,329
838,131
745,265
692,678
578,139
—
8,862
6,031
3,925
4,753
4,635
5,944
5,939
3,722
3,914
Female condom d
3,308
—
2,826
1,076
1,827
1,337
991
1,581
921
765
541
Contraceptive sponge d
651
313,688
104,779
133,099
123,844
111,160
105,705
116,635
115,002
113,016
95,798
Withdrawal or other e
70,982
25,906
9,702
9,446
8,784
10,409
12,633
14,379
17,105
12,676
11,753
FAM f or LAM
12,648
19,861
23,226
22,075
16,882
13,627
15,598
8,346
7,061
4,926
4,028
Spermicide
2,911
Other
Abstinence d
—
44,939
49,022
53,987
61,329
62,380
75,534
69,924
71,737
72,486
70,098
No Method
Pregnant or seeking
287,485
358,492
373,111
383,303
381,848
395,633
400,194
361,056
377,547
356,750
330,279
pregnancy
378,605
298,658
326,885
308,061
283,848
260,946
238,347
229,541
183,613
181,657
Other reason
175,111
146,417
195,245
139,537
142,145
248,458
273,961
160,788
96,687
96,590
106,017
Method Unknown
98,208
4,823,404
4,740,168
4,721,869
4,691,857
4,723,662
4,811,691
4,822,570
4,635,195
4,378,744
4,184,587
Total Female Users
3,764,622
4,010,897
3,887,773
3,882,336
3,858,348
3,809,508
3,881,151
4,023,241
3,947,911
3,720,994
3,540,163
Using a Method
3,161,024
666,090
657,150
699,996
691,364
665,696
656,579
638,541
590,597
561,160
538,407
Not Using a Method
505,390
146,417
195,245
139,537
142,145
248,458
273,961
160,788
96,687
96,590
106,017
Method Unknown
98,208
83%
82%
82%
82%
81%
81%
83%
85%
85%
85%
Using a Method
84%
14%
14%
15%
15%
14%
14%
13%
13%
13%
13%
Not Using a Method
13%
3%
4%
3%
3%
5%
6%
3%
2%
2%
3%
Method Unknown
3%
FAM=fertility awareness-based method. LAM=lactational amenorrhea method. Note: Due to rounding, percentages may not sum to 100%.
a
See reference note 10.
b
For 2004, sterilization figures include both female and male (vasectomy) sterilization users. Beginning in 2005, female and male sterilization figures are reported separately.
c
For 2005–2014, hormonal injection figures include both 1- and 3-month hormonal injection users.
d
For 2004, grantees reported these methods in the Withdrawal/Other method category.
e
For 2004, the Withdrawal/Other category includes rhythm/calendar, sponge, vaginal suppositories, douching, abstinence, and other methods not listed in Table 3 of the 2001 version
of the Title X FPAR: Forms and Instructions. The Withdrawal/Other category excludes rhythm/calendar, sponge, vaginal suppositories, and abstinence.
f
For 2004, the FAM category includes only safe period by temperature or cervical mucus test. For 2005–2010, the FAM category includes Calendar Rhythm, Standard Days®, Basal
Body Temperature, Cervical Mucus, and SymptoThermal methods. For 2011–2014, the FAM category includes Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and
SymptoThermal methods. For 2005–2014, the FAM category also includes postpartum women relying on LAM.
— Data are not available.

Family Planning Annual Report: 2014 National Summary

Exhibit A–8b.

Distribution of female family planning users who reported a primary contraceptive method at exit from the encounter, by
primary contraceptive method and year: 2004–2014

Primary Method
Highly Effective
Vasectomy b

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

a

—

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

2%

2%

2%

2%

2%

2%

2%

2%

2%

2%

Sterilization b

3%

Hormonal implant

0%†

0%†

0%†

0%†

0%†

1%

1%

2%

2%

3%

4%

Intrauterine device

2%

2%

3%

4%

5%

6%

6%

7%

8%

8%

8%

Moderately Effective a
Hormonal injection c

18%

19%

16%

15%

15%

16%

16%

16%

16%

17%

18%

Vaginal ring d

—

2%

3%

4%

4%

4%

5%

5%

4%

4%

4%

Contraceptive patch d

—

7%

4%

3%

3%

3%

2%

2%

2%

2%

2%

Oral contraceptive

49%

48%

48%

47%

46%

44%

42%

39%

38%

37%

36%

Cervical cap/diaphragm
Less Effective a
Male condom
Female condom

0%†
18%

d

Contraceptive sponge d

0%†
18%

0%†
19%

0%†
19%

0%†
19%

0%†
19%

0%†
20%

0%†
21%

0%†
20%

0%†
20%

0%†
18%

—

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

—

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Withdrawal or other e

8%

3%

3%

3%

3%

3%

3%

3%

3%

3%

2%

FAM or LAM f

1%

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Spermicide

0%†

1%

1%

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

1%

1%

1%

2%

2%

2%

2%

2%

2%

2%

Other
Abstinence d
Total Using a Method
Percentage
Number

—
100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

4,010,897

3,887,773

3,882,336

3,858,348

3,809,508

3,881,151

4,023,241

3,947,911

3,720,994

3,540,163

3,161,024

A-17

FAM=fertility awareness-based method. LAM=lactational amenorrhea method. Note: Due to rounding, percentages may not sum to 100%.
a
See reference note 10.
b
For 2004, sterilization figures include both female and male (vasectomy) sterilization users. Beginning in 2005, female and male sterilization figures are reported separately.
c
For 2005–2014, hormonal injection figures include both 1- and 3-month hormonal injection users.
d
For 2004, grantees reported these methods in the Withdrawal/Other method category.
e
For 2004, the Withdrawal/Other category includes rhythm/calendar, sponge, vaginal suppositories, douching, abstinence, and other methods not listed in Table 3 of the 2001 version
of the Title X FPAR: Forms and Instructions. Beginning in 2005, the Withdrawal/Other category excludes rhythm/calendar, sponge, vaginal suppositories, and abstinence.
f
For2004, the FAM category includes only safe period by temperature or cervical mucus test. For 2005–2010, the FAM category includes Calendar Rhythm, Standard Days ®, Basal
Body Temperature, Cervical Mucus, and SymptoThermal methods. For 2011–2014, the FAM category includes Calendar Rhythm, Standard Days®, TwoDay, Billings Ovulation, and
SymptoThermal methods. For 2005–2014, the FAM category also included postpartum women who rely on LAM.
— Data are not available.
† Percentage is less than 0.5%.

A-18

Exhibit A–8c.

2014

Number and distribution of female family planning users who reported a primary contraceptive method at exit from the
encounter, by level of method effectiveness and year: 2004–2014

Highly effective, 15%

2013

14%

2012

12%

Moderately effective, 61%
62%
62%

2011

11%

62%

2010

10%

65%

2009

9%

67%

Family Planning Annual Report: 2014 National Summary

8%

2008
2007

6%

2006

5%

2005

5%

2004

5%

Less effective, 21%

3.16 million

23%

3.54 million

24%

3.72 million

25%

3.95 million

23%

4.02 million

23%

3.88 million

68%

23%

3.81 million

70%

23%

3.86 million

24%

3.88 million

70%
72%

22%

68%

27%

0%

3.89 million
4.01 million
100%

Highly effective

Moderately effective

Less effective

Abstinence

Note: Due to rounding, the percentages in each year may not sum to 100%, and percentages in combined or aggregated categories may not match the sum of individual percentages
included in the aggregated categories. Highly effective methods include vasectomy (male sterilization), female sterilization, implant, and intrauterine devices/systems. Moderately
effective methods include injectable contraception, vaginal ring, contraceptive patch, pills, diaphragm with spermicidal cream/jelly, and the cervical cap. Less-effective methods
include male condoms, female condoms, the sponge, withdrawal, fertility awareness-based (FAM) and lactational amenorrhea (LAM) methods, spermicides, and other methods not
listed in Table 7. Because of combined FPAR reporting categories (e.g., FAM and LAM, diaphragm and cervical cap, or withdrawal and other), the FPAR data may vary slightly
from the moderately and less effective method categories defined in reference note 10.

Number and percentage of female users who received a Pap test, number of Pap tests performed, and percentage of Pap tests
performed with an ASC or higher result, by year: 2005–2014

Screening Measures

2005

Female Users Who Received a Pap Test
Number
Percentage
Pap Tests Performed
Number
Percentage with an ASC or higher result

2006

2007

2008

2009

2010

2011

2012

2013

2014

2,447,498

2,326,153

2,272,571

2,088,218

2,035,017

1,727,251

1,444,418

1,237,328

988,114

785,540

52%

49%

48%

44%

42%

36%

31%

28%

24%

21%

2,644,413

2,477,209

2,470,674

2,209,087

2,190,127

1,810,620

1,522,777

1,308,667

1,043,671

813,858

9%

10%

10%

11%

12%

13%

15%

14%

14%

14%

ASC=atypical squamous cells.
Number and percentage of female users who received a Pap test, by year: 2005–2014

3.0

100%
2.45

2.33

2.27

2.09

80%
2.04

2.0

1.73

60%
1.44

52%

49%

48%

1.0

1.24
44%

42%

0.99
36%

31%

28%

24%

40%
0.79
21%

0.0

20%

0%
2005

2006

2007

2008

2009

Number of female users tested

2010

2011

2012

2013

2014

Percentage of female users tested

Percentage of female users tested

Exhibit A–9b.

Female users tested (in millions)

Family Planning Annual Report: 2014 National Summary

Exhibit A–9a.

A-19

A-20

Exhibit A–10a. Number and percentage of female users under 25 tested for chlamydia, by year: 2005–2014
Chlamydia Testing Measures
Number tested

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

1,375,787

1,387,222

1,385,623

1,435,430

1,433,829

1,442,176

1,357,231

1,268,269

1,181,534

1,011,474

50%

51%

52%

55%

55%

57%

58%

59%

60%

58%

Percentage tested

1.5

1.38

1.39

1.39

1.44

1.43

1.44

100%
1.36

1.27

1.18

80%
1.01

1.0

60%
50%

51%

52%

55%

55%

57%

58%

59%

60%

58%
40%

0.5
20%

0.0

0%
2005

2006

2007

2008

2009

Number of female users < 25 years tested

2010

2011

2012

2013

2014

Percentage of female users < 25 years tested

Percentage of female users < 25 years tested

Family Planning Annual Report: 2014 National Summary

Female users < 25 years tested (in millions)

Exhibit A–10b. Number and percentage of female users under 25 tested for chlamydia, by year: 2005–2014

Number of confidential HIV tests performed and number of tests per 10 users: 2004–2014

HIV Testing
Measures
Tests performed

2004

2005

2006

2007

2008

2009

530,569

607,974

652,426

764,126

833,105

997,765

1.0

1.2

1.3

1.5

1.6

1.9

Tests per 10 users

2010

2011

2012

2013

2014

1,101,665

1,283,375

1,249,867

1,187,631

1,031,624

2.1

2.6

2.6

2.6

2.5

Number of confidential HIV tests performed and number of tests per 10 users: 2004–2014

1.5

4.0
1.28

1.25

1.10

1.03

1.00

1.0
0.76
0.53

0.61

0.83
2.6

1.9
1.5

1.0

1.2

2.6

2.6

0.65

0.5

3.5

1.19

3.0

2.5
2.5
2.0

2.1

1.6

1.5

1.3

1.0

0.0

0.5
2004

2005

2006

2007

2008

Number of tests performed

2009

2010

2011

2012

2013

Number of tests per 10 users

2014

Number of tests per 10 users

Exhibit A-11b.

Number of tests performed (in millions)

Family Planning Annual Report: 2014 National Summary

Exhibit A-11a.

A-21

A-22

Exhibit A–12a. Actual and adjusted (constant 2014$, 2004$, and 1981$) total, Title X, and Medicaid revenue, by year: 2004–2014
Change
Revenue

2004
($)

2005
($)

2006
($)

2007
($)

2008
($)

2009
($)

2010
($)

2011
($)

2012
($)

2013
($)

2014
($)

2004–
2014

2013–
2014

Total
Actual a

982,537,801 1,004,633,020 1,081,431,527 1,140,511,162 1,211,489,469 1,231,311,085 1,293,835,909 1,286,574,610 1,260,206,935 1,284,715,163 1,243,901,947

27%

−3%

2014$ b

1,379,228,329 1,353,084,015 1,400,199,714 1,414,211,229 1,448,536,293 1,426,973,282 1,449,934,535 1,399,212,327 1,322,092,911 1,315,435,864 1,243,901,947

−10%

−5%

Family Planning Annual Report: 2014 National Summary

2004$ b

982,537,801

963,913,055

997,477,444 1,007,458,999 1,031,911,566 1,016,550,459 1,032,907,649

996,774,047

941,835,542

937,093,180

886,133,687

−10%

−5%

1981$ b

262,664,894

257,685,883

266,658,755

269,327,156

275,864,137

271,757,604

276,130,423

266,470,714

251,783,832

250,516,042

236,892,882

−10%

−5%

Title X
Actual a

252,141,527

249,562,677

262,983,478

255,337,864

259,743,981

266,393,881

279,295,186

276,002,719

267,095,215

253,655,493

249,517,445

−1%

−2%

2014$ b

353,941,331

336,122,009

340,501,808

316,613,889

310,566,945

308,725,354

312,991,573

300,166,352

280,211,670

259,721,020

249,517,445

−30%

−4%

2004$ b

252,141,527

239,447,358

242,567,450

225,550,119

221,242,384

219,930,467

222,969,645

213,833,186

199,617,824

185,020,648

177,751,803

−30%

−4%

1981$ b

67,405,781

64,012,209

64,846,313

60,297,017

59,145,416

58,794,698

59,607,171

57,164,692

53,364,455

49,462,147

47,518,944

−30%

−4%

Medicaid c
Actual a

277,174,817

311,226,237

320,457,197

349,919,735

407,561,796

450,028,613

482,175,678

506,887,574

499,181,475

508,494,458

493,061,463

78%

−3%

2014$ b

389,081,580

419,173,208

414,916,769

433,893,534

487,307,623

521,540,669

540,349,176

551,264,837

523,695,173

520,653,812

493,061,463

27%

−5%

2004$ b

277,174,817

298,611,560

295,579,348

309,098,058

347,149,308

371,536,323

384,935,170

392,711,293

373,071,154

370,904,542

351,248,242

27%

−5%

1981$ b

74,098,008

79,828,759

79,018,149

82,632,148

92,804,507

99,323,964

102,905,919

104,984,735

99,734,275

99,155,068

93,900,288

27%

−5%

a

Revenue is shown in actual dollars (unadjusted) for each year.

b

Revenue is shown in constant 2014 dollars (2014$), 2004 dollars (2004$), or 1981 dollars (1981$), based on the consumer price index for medical care, which includes medical care
commodities and medical care services (Source: U.S. Department of Labor, Bureau of Labor Statistics, http://data.bls.gov/cgi-bin/srgate).

c

Medicaid revenue for 2005–2014 includes separately reported Children’s Health Insurance Program revenue.

$1,600
$1,379
$1,400

Revenue in millions (constant 2014$)

Family Planning Annual Report: 2014 National Summary

Exhibit A–12b. Total, Title X, and Medicaid adjusted (constant 2014$) revenue, by year: 2004–2014

$1,244

$1,200
$1,000
$800
$600
$400

$493
$389
$250

$354
$200
$0
2004

2005

2006

Total revenue

2007

2008

2009

2010

Medicaid

Note: For 2005–2014, Medicaid revenue includes separately reported Children’s Health Insurance Program revenue.

2011

2012

2013

Title X

2014

A-23

A-24

Exhibit A–12c. Total actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$) revenue, by year: 2004–2014

Family Planning Annual Report: 2014 National Summary

Total revenue in millions

$1,500

$1,379

$1,350

$1,244

$1,200

$1,244

$1,050

$983

$900

$983

$886

$750
$600
$450
$300

$263

$237

$150
$0
2004

2005

2006

Actual (unadjusted)

2007

2008

Adjusted (2014$)

2009

2010

2011

Adjusted (2004$)

2012

2013

2014

Adjusted (1981$)

$400
$354
$350

Title X revenue in millions

Family Planning Annual Report: 2014 National Summary

Exhibit A–12d. Title X actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$) revenue, by year: 2004–2014

$300
$250

$252
$250

$252

$250

$200
$178

$150
$100

$67

$48

$50
$0
2004

2005

2006

Actual (unadjusted)

2007

2008

2009

Adjusted (2014$)

2010

2011

Adjusted (2004$)

2012

2013

2014

Adjusted (1981$)

A-25

A-26

Exhibit A–12e. Medicaid actual (unadjusted) and adjusted (constant 2014$, 2004$, and 1981$) revenue, by year: 2004–2014

$600
$493

Family Planning Annual Report: 2014 National Summary

Medicaid revenue in millions

$500
$493
$400

$300

$389
$351

$277
$277

$200

$100

$94

$74

$0
2004

2005

2006

Actual (unadjusted)

2007

2008

2009

Adjusted (2014$)

2010

2011

Adjusted (2004$)

Note: For 2005–2014 Medicaid revenue includes separately reported Children’s Health Insurance Program revenue.

2012

2013

2014

Adjusted (1981$)

Family Planning Annual Report: 2014 National Summary

Exhibit A–13a. Amount of Title X project revenue, by revenue source and year: 2004–2014
Revenue Sources
Title X

2004
($)

2005
($)

2006
($)

2007
($)

2008
($)

2009
($)

2010
($)

2011
($)

2012
($)

2013
($)

2014
($)

252,141,527

249,562,677

262,983,478

255,337,864

259,743,981

266,393,881

279,295,186

276,002,719

267,095,215

253,655,493

249,517,445

Payment for Services
Client fees

99,774,741

101,353,959

102,527,805

94,273,992

94,531,003

80,940,857

84,540,815

72,156,363

70,400,120

69,425,823

53,170,034

Third-party payers
Medicaid

277,174,817

311,066,271

320,154,915

349,672,196

407,349,628

449,834,131

481,262,633

506,608,330

498,739,261

505,709,855

490,470,842

755,938

850,289

695,725

523,170

826,424

843,164

1,913,519

2,002,181

1,173,110

1,864,987

3,083,719

CHIP

—

159,966

302,282

247,539

212,168

194,482

913,045

279,244

442,214

2,784,603

2,590,621

Other

15,231,967

2,137,736

3,173,806

3,042,991

3,855,406

4,903,482

2,466,949

4,088,072

3,743,183

10,848,382

10,202,966

Private

23,923,861

31,794,914

37,263,692

46,403,049

45,067,919

48,445,935

50,409,637

51,655,083

63,955,467

69,210,207

95,138,355

Subtotal

416,861,324

447,363,135

464,118,225

494,162,937

551,842,548

585,162,051

621,506,598

636,789,273

638,453,355

659,843,857

654,656,537

Other Revenue
MCH block grant

32,992,292

24,384,126

22,806,213

23,484,206

23,058,822

21,044,962

21,205,336

25,512,030

24,439,148

19,852,391

23,095,828

SS block grant

30,835,001

27,232,575

28,443,123

28,593,275

27,333,993

30,841,136

34,001,848

23,736,983

11,229,640

8,805,626

5,601,590

—

16,986,542

10,521,097

23,460,554

22,325,121

15,580,002

14,475,023

14,517,155

13,548,818

13,268,175

10,570,729

State government

125,848,881

115,558,888

133,618,734

138,760,608

147,447,953

153,830,395

135,464,470

125,392,165

117,468,476

131,054,838

120,974,720

Local government

50,028,918

56,251,710

93,388,186

99,510,026

101,295,242

84,666,243

91,289,586

84,214,372

87,010,991

93,770,370

80,388,864

Medicare

TANF

BPHC

3,959,649

6,172,992

5,847,921

7,177,359

9,531,860

4,965,372

4,090,546

5,289,075

4,625,737

11,461,645

10,080,722

Other

69,870,209

61,120,375

59,704,550

70,024,333

68,909,949

68,827,043

92,507,316

95,120,838

96,335,555

93,002,768

89,015,512

313,534,950

307,707,208

354,329,824

391,010,361

399,902,940

379,755,153

393,034,125

373,782,618

354,658,365

371,215,813

339,727,965

Subtotal
Total Revenue
Actual

982,537,801 1,004,633,020 1,081,431,527 1,140,511,162 1,211,489,469 1,231,311,085 1,293,835,909 1,286,574,610 1,260,206,935 1,284,715,163 1,243,901,947

2014$

a

2004$

a

1,379,228,329 1,353,084,015 1,400,199,714 1,414,211,229 1,448,536,293 1,426,973,282 1,449,934,535 1,399,212,327 1,322,092,911 1,315,435,864 1,243,901,947
982,537,801

963,913,055

997,477,444 1,007,458,999 1,031,911,566 1,016,550,459 1,032,907,649

996,774,047

941,835,542

937,093,180

886,133,687

1981$ a

262,664,894

257,685,883

266,658,755

266,470,714

251,783,832

250,516,042

236,892,882

269,327,156

275,864,137

271,757,604

276,130,423

BPHC=Bureau of Primary Health Care. CHIP=Children’s Health Insurance Program. MCH=Maternal and Child Health. SS=Social Services. TANF=Temporary Assistance for Needy Families.
Note: Unless otherwise noted, revenue is shown in actual dollars (unadjusted) for each year.
a
Revenue is shown in constant 2014 dollars (2014$), 2004 dollars (2004$), or 1981 dollars (1981$), based on the consumer price index for medical care, which includes medical care
commodities and medical care services (Source: U.S. Department of Labor, Bureau of Labor Statistics, http://data.bls.gov/cgi-bin/srgate).
— Data are not available.

A-27

A-28

Exhibit A–13b. Distribution of Title X project revenue, by revenue source and year: 2004–2014
Revenue Sources

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

Title X

26%

25%

24%

22%

21%

22%

22%

21%

21%

20%

20%

Payment for Services
Client fees

10%

10%

9%

8%

8%

7%

7%

6%

6%

5%

4%

Third-party payers
Medicaid

28%

31%

30%

31%

34%

37%

37%

39%

40%

39%

39%

Medicare
CHIP

0%†
—

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

Other

2%

0%†

0%†

0%†

0%†

0%†

0%†

0%†

0%†

1%

1%

Private

2%

3%

3%

4%

4%

4%

4%

4%

5%

5%

8%

Subtotal

42%

45%

43%

43%

46%

48%

48%

49%

51%

51%

53%

3%

2%

2%

2%

2%

2%

2%

2%

2%

2%

2%

Other Revenue
MCH block grant

Family Planning Annual Report: 2014 National Summary

SS block grant

3%

3%

3%

3%

2%

3%

3%

2%

1%

1%

0%†

TANF

0%

2%

1%

2%

2%

1%

1%

1%

1%

1%

1%

State government

13%

12%

12%

12%

12%

12%

10%

10%

9%

10%

10%

Local government

5%

6%

9%

9%

8%

7%

7%

7%

7%

7%

6%

BPHC

0%†

1%

1%

1%

1%

0%†

0%†

0%†

0%†

1%

1%

Other

7%

6%

6%

6%

6%

6%

7%

7%

8%

7%

7%

Subtotal

32%

31%

33%

34%

33%

31%

30%

29%

28%

29%

27%

Total Revenue

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

100%

BPHC=Bureau of Primary Health Care. CHIP=Children’s Health Insurance Program. MCH=Maternal and Child Health. SS=Social Services. TANF=Temporary Assistance for Needy
Families.
Note: Due to rounding, percentages may not sum to 100%.
— Data are not available.
† Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

Exhibit A–13c. Amount and distribution of Title X project revenue, by revenue source and year: 2004–2014

2014

Medicaid, 40%

Title X, 20%

State/Local Govt,
16%

Other, 24%

$1.2 billion

2013

40%

20%

18%

23%

$1.3 billion

2012

40%

21%

16%

23%

$1.3 billion

2011

39%

21%

16%

23%

$1.3 billion

18%

24%

$1.3 billion

19%

22%

$1.2 billion

2010

37%

2009

37%

22%
22%

34%

2008

21%

2007

31%

22%

2006

30%

24%

31%

2005

25%

28%

2004

26%

21%
21%
21%
17%
18%

24%

$1.2 billion

26%

$1.1 billion

25%

$1.1 billion

27%

$1.0 billion

28%

$1.0 billion

0%

100%

Medicaid

Title X

State/local government

Other

Notes: Revenue figures are unadjusted. For 2005–2014, Medicaid revenue includes separately reported Children’s Health Insurance Program revenue. The Other revenue category
includes revenue from the Bureau of Primary Health Care and other federal grants; other public and private third parties; block grants; Temporary Assistance for Needy Families
revenue; and revenue reported as Other in the FPAR revenue table. Due to rounding, percentages in each year may not sum to 100%, and percentages in combined or
aggregated categories may not match the sum of the individual percentages that are included in the aggregated categories.

A-29

This page intentionally left blank.

A-30

Family Planning Annual Report: 2014 National Summary

Appendix B
State Exhibits

Exhibit B–1.

Number and distribution of all family planning users, by sex and state, and distribution of
all users, by state: 2014 (Source: FPAR Table 1)

State
Alabama

Male

Total

Female

Male

State Users as %
of All Users

92,797

900

93,697

99%

1%

2%

Alaska

7,555

1,066

8,621

88%

12%

0%†

Arizona

29,790

3,778

33,568

89%

11%

1%

Arkansas

54,359

964

55,323

98%

2%

1%

California

954,569

120,424

1,074,993

89%

11%

26%

Colorado

47,513

8,190

55,703

85%

15%

1%

Connecticut

35,617

5,128

40,745

87%

13%

1%

Delaware

14,716

3,466

18,182

81%

19%

0%†

District of Columbia

32,668

12,216

44,884

73%

27%

1%

Florida

159,715

4,163

163,878

97%

3%

4%

Georgia

97,483

4,840

102,323

95%

5%

2%

Hawaii

17,992

847

18,839

96%

4%

0%†

Idaho

16,726

844

17,570

95%

5%

0%†

Illinois

86,828

4,209

91,037

95%

5%

2%

Indiana

30,661

2,538

33,199

92%

8%

1%

Iowa

43,472

3,010

46,482

94%

6%

1%

Kansas

25,865

2,458

28,323

91%

9%

1%

Kentucky

64,523

5,106

69,629

93%

7%

2%

Louisiana

35,630

6,421

42,051

85%

15%

1%

Maine

20,006

2,531

22,537

89%

11%

1%

Maryland

61,823

6,451

68,274

91%

9%

2%

Massachusetts

56,159

9,145

65,304

86%

14%

2%

Michigan

77,339

3,151

80,490

96%

4%

2%

Minnesota

49,198

7,621

56,819

87%

13%

1%

Mississippi

47,652

354

48,006

99%

1%

1%

Missouri

45,728

3,743

49,471

92%

8%

1%

Montana

18,833

2,364

21,197

89%

11%

1%

Nebraska

21,648

2,481

24,129

90%

10%

1%

Nevada

12,765

579

13,344

96%

4%

0%†

New Hampshire

17,699

1,700

19,399

91%

9%

0%†

New Jersey

84,648

8,454

93,102

91%

9%

2%

New Mexico

22,769

3,351

26,120

87%

13%

1%

285,372

27,638

313,010

91%

9%

8%

New York
†

Female

Percentage is less than 0.5%.

B-2

(continued)

Family Planning Annual Report: 2014 National Summary

Exhibit B–1.

Number and distribution of all family planning users, by sex and state, and distribution of
all users, by state: 2014 (Source: FPAR Table 1) (continued)
Total

Female

Male

State Users as
% of All Users

2,218

110,167

98%

2%

3%

8,356

1,437

9,793

85%

15%

0%†

Ohio

65,221

10,555

75,776

86%

14%

2%

Oklahoma

52,732

799

53,531

99%

1%

1%

Oregon

54,788

5,011

59,799

92%

8%

1%

Pennsylvania

193,310

22,681

215,991

89%

11%

5%

Rhode Island

22,897

4,404

27,301

84%

16%

1%

South Carolina

83,534

5,641

89,175

94%

6%

2%

South Dakota

6,197

417

6,614

94%

6%

0%†

92,983

643

93,626

99%

1%

2%

107,537

13,732

121,269

89%

11%

3%

29,991

5,186

35,177

85%

15%

1%

Vermont

7,796

923

8,719

89%

11%

0%†

Virginia

62,017

4,459

66,476

93%

7%

2%

Washington

74,842

4,838

79,680

94%

6%

2%

West Virginia

50,458

3,892

54,350

93%

7%

1%

Wisconsin

35,742

4,489

40,231

89%

11%

1%

Wyoming

7,950

1,075

9,025

88%

12%

0%†

American Samoa

909

91

1,000

91%

9%

0%†

Comm. of the Northern
Mariana Islands

803

5

808

99%

1%

0%†

3,402

811

4,213

81%

19%

0%†

352

41

393

90%

10%

0%†

19,236

710

19,946

96%

4%

0%†

Republic of the
Marshall Islands

1,183

88

1,271

93%

7%

0%†

Republic of Palau

1,305

47

1,352

97%

3%

0%†

U.S. Virgin Islands

3,014

337

3,351

90%

10%

0%†

3,764,622

364,661

4,129,283

91%

9%

73%–99%

1%–27%

State

Female

North Carolina

107,949

North Dakota

Tennessee
Texas
Utah

Male

Territories & FAS

Federated States of
Micronesia
Guam
Puerto Rico

Total All Users
Range

100%
0%†–26%

FAS=Freely Associated States.
†

Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

B-3

Exhibit B–2.

Number and distribution of all family planning users, by user income level and state:
2014 (Source: FPAR Table 4)

State

Under
101%

101%
to 250%

Total

Under
101%

101%
to 250%

Over
250%

Alabama

71,684

20,255

1,650

108

93,697

77%

22%

2%

0%†

Alaska

4,467

2,257

1,593

304

8,621

52%

26%

18%

4%

Arizona

24,547

3,446

5,515

60

33,568

73%

10%

16%

0%†

Arkansas

44,986

9,647

687

3

55,323

81%

17%

1%

0%†

California

807,175

213,649

31,292

22,877

1,074,993

75%

20%

3%

2%

Colorado

41,743

11,644

2,316

0

55,703

75%

21%

4%

0%

Connecticut

18,811

17,990

2,666

1,278

40,745

46%

44%

7%

3%

Delaware

11,701

3,183

1,008

2,290

18,182

64%

18%

6%

13%

District of Columbia

28,114

8,516

1,772

6,482

44,884

63%

19%

4%

14%

Florida

97,802

28,969

31,827

5,280

163,878

60%

18%

19%

3%

Georgia

78,118

12,646

1,100

10,459

102,323

76%

12%

1%

10%

Hawaii

15,692

2,554

590

3

18,839

83%

14%

3%

0%†

Idaho

11,561

5,274

706

29

17,570

66%

30%

4%

0%†

Illinois

74,781

14,557

1,692

7

91,037

82%

16%

2%

0%†

Indiana

24,155

8,124

920

0

33,199

73%

24%

3%

0%

Iowa

26,642

9,579

1,840

8,421

46,482

57%

21%

4%

18%

Kansas

17,406

8,000

1,603

1,314

28,323

61%

28%

6%

5%

Kentucky

54,499

11,556

2,793

781

69,629

78%

17%

4%

1%

Louisiana

34,089

6,534

1,399

29

42,051

81%

16%

3%

0%†

9,925

8,416

2,544

1,652

22,537

44%

37%

11%

7%

Maryland

57,101

7,739

999

2,435

68,274

84%

11%

1%

4%

Massachusetts

42,108

18,250

2,958

1,988

65,304

64%

28%

5%

3%

Michigan

50,307

24,249

5,903

31

80,490

63%

30%

7%

0%†

Minnesota

30,779

19,273

4,666

2,101

56,819

54%

34%

8%

4%

Mississippi

44,013

3,877

111

5

48,006

92%

8%

0%†

0%†

Missouri

32,942

12,823

3,706

0

49,471

67%

26%

7%

0%

Montana

10,960

6,067

4,157

13

21,197

52%

29%

20%

0%†

Nebraska

12,052

7,313

1,382

3,382

24,129

50%

30%

6%

14%

Nevada

9,505

3,162

498

179

13,344

71%

24%

4%

1%

New Hampshire

9,826

5,789

1,763

2,021

19,399

51%

30%

9%

10%

New Jersey

33,688

55,847

3,567

0

93,102

36%

60%

4%

0%

New Mexico

19,843

4,417

448

1,412

26,120

76%

17%

2%

5%

197,489

73,787

29,125

12,609

313,010

63%

24%

9%

4%

Maine

New York

UK/NR=unknown or not reported.
†

Over
250%

UK/NR

UK/NR

(continued)

Percentage is less than 0.5%.

B-4

Family Planning Annual Report: 2014 National Summary

Exhibit B–2.

Number and distribution of all family planning users, by user income level and state:
2014 (Source: FPAR Table 4) (continued)

State

Under
101%

101%
to 250%

North Carolina

61,276

23,121

North Dakota

3,827

Ohio

Over
250%

UK/NR

Total

Under
101%

9,535

16,235

110,167

56%

3,549

2,173

244

9,793

40,503

25,853

6,331

3,089

Oklahoma

38,926

13,033

1,014

Oregon

40,609

14,697

Pennsylvania

120,947

Rhode Island

101%
to 250%

Over
250%

UK/NR

21%

9%

15%

39%

36%

22%

2%

75,776

53%

34%

8%

4%

558

53,531

73%

24%

2%

1%

1,572

2,921

59,799

68%

25%

3%

5%

59,076

26,711

9,257

215,991

56%

27%

12%

4%

15,178

4,000

906

7,217

27,301

56%

15%

3%

26%

South Carolina

85,384

3,095

696

0

89,175

96%

3%

1%

0%

South Dakota

4,222

1,653

574

165

6,614

64%

25%

9%

2%

Tennessee

73,870

15,068

2,666

2,022

93,626

79%

16%

3%

2%

Texas

86,004

21,467

6,232

7,566

121,269

71%

18%

5%

6%

Utah

23,733

9,637

1,807

0

35,177

67%

27%

5%

0%

Vermont

4,110

2,593

929

1,087

8,719

47%

30%

11%

12%

Virginia

37,638

15,677

3,428

9,733

66,476

57%

24%

5%

15%

Washington

48,637

21,936

3,518

5,589

79,680

61%

28%

4%

7%

West Virginia

48,558

5,774

12

6

54,350

89%

11%

0%†

0%†

Wisconsin

26,354

11,125

2,265

487

40,231

66%

28%

6%

1%

Wyoming

4,924

3,049

1,052

0

9,025

55%

34%

12%

0%

1,000

0

0

0

1,000

100%

0%

0%

0%

757

28

0

23

808

94%

3%

0%

3%

4,210

0

0

3

4,213

100%

0%

0%

0%†

302

4

13

74

393

77%

1%

3%

19%

15,708

3,478

649

111

19,946

79%

17%

3%

1%

Republic of the
Marshall Islands

1,271

0

0

0

1,271

100%

0%

0%

0%

Republic of Palau

1,213

129

10

0

1,352

90%

10%

1%

0%

U.S. Virgin Islands

2,978

344

29

0

3,351

89%

10%

1%

0%

2,840,650

907,775

226,918

153,940

4,129,283

69%

22%

5%

4%

Territories & FAS
American Samoa
Comm. of the Northern
Mariana Islands
Federated States of
Micronesia
Guam
Puerto Rico

Total All Users
Range

36%–100% 0%–60% 0%–22% 0%–26%

UK/NR=unknown or not reported. FAS=Freely Associated States.
Note: Due to rounding, the percentages may not sum to 100%. Title X-funded agencies report user income as a percentage of
poverty based on guidelines issued by the U.S. Department of Health and Human Services (HHS). Each year, HHS announces
updates to its poverty guidelines in the Federal Register and on the HHS Website at http://aspe.hhs.gov/poverty.
†

Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

B-5

Exhibit B–3.

Number and distribution of all family planning users, by insurance status and state: 2014
(Source: FPAR Table 5)

State
Alabama

Public

Uninsured

UK/NR

Total

Public

Private

Uninsured

UK/NR

26,383

11,179

56,116

19

93,697

28%

12%

60%

0%†

Alaska

1,117

2,907

4,581

16

8,621

13%

34%

53%

0%†

Arizona

3,084

3,147

27,322

15

33,568

9%

9%

81%

0%†

Arkansas

22,154

12,939

20,230

0

55,323

40%

23%

37%

0%

California

246,223

33,752

774,441

20,577

1,074,993

23%

3%

72%

2%

Colorado

16,002

6,825

29,271

3,605

55,703

29%

12%

53%

6%

Connecticut

15,738

13,419

11,256

332

40,745

39%

33%

28%

1%

5,888

3,920

7,340

1,034

18,182

32%

22%

40%

6%

District of Columbia

33,790

3,868

3,929

3,297

44,884

75%

9%

9%

7%

Florida

70,498

41,503

49,303

2,574

163,878

43%

25%

30%

2%

Georgia

22,393

14,973

59,130

5,827

102,323

22%

15%

58%

6%

Hawaii

8,335

4,751

5,461

292

18,839

44%

25%

29%

2%

Idaho

1,404

4,283

11,411

472

17,570

8%

24%

65%

3%

Illinois

40,121

9,744

40,692

480

91,037

44%

11%

45%

1%

Indiana

3,494

3,618

25,013

1,074

33,199

11%

11%

75%

3%

11,401

17,037

17,391

653

46,482

25%

37%

37%

1%

3,745

4,826

19,544

208

28,323

13%

17%

69%

1%

Kentucky

27,014

6,549

34,023

2,043

69,629

39%

9%

49%

3%

Louisiana

4,282

21,239

16,340

190

42,051

10%

51%

39%

0%†

Maine

5,325

8,960

8,226

26

22,537

24%

40%

36%

0%†

Maryland

23,482

12,726

29,115

2,951

68,274

34%

19%

43%

4%

Massachusetts

35,351

14,809

14,218

926

65,304

54%

23%

22%

1%

Michigan

28,863

14,340

36,881

406

80,490

36%

18%

46%

1%

Minnesota

12,964

17,276

26,448

131

56,819

23%

30%

47%

0%†

Mississippi

17,516

3,864

24,816

1,810

48,006

36%

8%

52%

4%

Missouri

11,146

8,300

30,025

0

49,471

23%

17%

61%

0%

Montana

1,892

9,212

9,607

486

21,197

9%

43%

45%

2%

Nebraska

1,799

6,225

15,690

415

24,129

7%

26%

65%

2%

Nevada

2,605

974

9,710

55

13,344

20%

7%

73%

0%†

New Hampshire

4,540

6,971

7,843

45

19,399

23%

36%

40%

0%†

New Jersey

25,850

11,026

56,183

43

93,102

28%

12%

60%

0%†

New Mexico

4,369

4,086

17,320

345

26,120

17%

16%

66%

1%

139,731

37,992

118,470

16,817

313,010

45%

12%

38%

5%

Delaware

Iowa
Kansas

New York

UK/NR=unknown or not reported.
†

Private

(continued)

Percentage is less than 0.5%.

B-6

Family Planning Annual Report: 2014 National Summary

Exhibit B–3.

Number and distribution of all family planning users, by insurance status and state: 2014
(Source: FPAR Table 5) (continued)

State
North Carolina

Public

Private

Uninsured

UK/NR

Total

Public

Private

Uninsured

UK/NR

30,401

7,297

43,025

29,444

110,167

28%

7%

39%

27%

521

3,455

4,502

1,315

9,793

5%

35%

46%

13%

Ohio

26,684

13,663

34,828

601

75,776

35%

18%

46%

1%

Oklahoma

11,807

7,048

34,671

5

53,531

22%

13%

65%

0%†

Oregon

16,705

8,374

32,964

1,756

59,799

28%

14%

55%

3%

Pennsylvania

63,011

53,101

93,630

6,249

215,991

29%

25%

43%

3%

Rhode Island

14,442

6,514

6,337

8

27,301

53%

24%

23%

0%†

South Carolina

27,171

5,550

56,454

0

89,175

30%

6%

63%

0%

261

3,487

2,202

664

6,614

4%

53%

33%

10%

Tennessee

37,480

4,461

51,051

634

93,626

40%

5%

55%

1%

Texas

21,161

4,864

94,843

401

121,269

17%

4%

78%

0%†

Utah

1,063

5,507

28,607

0

35,177

3%

16%

81%

0%

Vermont

3,342

3,278

2,099

0

8,719

38%

38%

24%

0%

Virginia

7,383

10,114

45,835

3,144

66,476

11%

15%

69%

5%

Washington

32,252

20,340

26,849

239

79,680

40%

26%

34%

0%†

West Virginia

17,057

12,469

24,824

0

54,350

31%

23%

46%

0%

Wisconsin

11,720

3,816

24,695

0

40,231

29%

9%

61%

0%

614

2,570

4,588

1,253

9,025

7%

28%

51%

14%

0

0

1,000

0

1,000

0%

0%

100%

0%

Comm. of the Northern
Mariana Islands

376

76

348

8

808

47%

9%

43%

1%

Federated States of
Micronesia

184

382

3,477

170

4,213

4%

9%

83%

4%

37

11

345

0

393

9%

3%

88%

0%

11,162

5,865

2,878

41

19,946

56%

29%

14%

0%†

Republic of the
Marshall Islands

0

0

4

1,267

1,271

0%

0%

0%†

Republic of Palau

1,324

16

12

0

1,352

98%

1%

1%

0%

991

347

1,963

50

3,351

30%

10%

59%

1%

1,215,648

559,845

2,239,377

114,413

4,129,283

29%

14%

54%

3%

North Dakota

South Dakota

Wyoming
Territories & FAS
American Samoa

Guam
Puerto Rico

U.S. Virgin Islands
Total Users
Range

0%–98% 0%–53%

100%

0%†–100% 0%–100%

UK/NR=unknown or not reported. FAS=Freely Associated States.
Note: Due to rounding, the percentages may not sum to 100%.
†

Percentage is less than 0.5%.

Family Planning Annual Report: 2014 National Summary

B-7

Exhibit B–4.

Number and distribution of female family planning users, by effectiveness level of the
users’ primary method at exit from the encounter and state: 2014 (Source: FPAR Table 7)

State

Highly
Effective
Permanent
Methods a

Highly
Effective
Reversible
Methods a

Moderately
Effective
Methods b

Less
Effective
Methods c

Total
At Risk d

Highly
Moderately
Effective
Effective
Methods a Methods b

Less
Effective
Methods c

Alabama

145

4,490

58,698

12,505

77,184

6%

76%

16%

Alaska

117

1,498

3,375

753

6,086

27%

55%

12%

Arizona

145

3,109

17,683

4,491

26,732

12%

66%

17%

Arkansas

1,232

4,076

23,562

5,084

41,504

13%

57%

12%

California

17,783

126,250

440,371

248,275

858,566

17%

51%

29%

Colorado

861

11,499

21,982

4,472

40,954

30%

54%

11%

1,048

3,771

13,172

12,232

31,406

15%

42%

39%

Delaware

288

848

4,639

1,652

12,807

9%

36%

13%

District of Columbia

935

4,286

10,419

2,071

28,568

18%

36%

7%

Florida

2,216

12,076

80,335

18,190

116,600

12%

69%

16%

Georgia

1,866

6,770

53,233

9,243

84,339

10%

63%

11%

Hawaii

485

2,102

7,047

2,321

13,016

20%

54%

18%

Idaho

556

1,451

10,941

1,708

15,115

13%

72%

11%

Illinois

2,358

10,133

42,054

11,107

68,037

18%

62%

16%

333

1,725

20,527

3,594

26,922

8%

76%

13%

Iowa

1,767

6,401

24,650

4,096

39,005

21%

63%

11%

Kansas

1,443

1,730

15,186

2,719

21,963

14%

69%

12%

Kentucky

2,585

2,850

33,654

17,179

58,571

9%

57%

29%

Louisiana

360

2,568

25,042

3,725

32,540

9%

77%

11%

Maine

916

2,949

10,076

2,176

17,938

22%

56%

12%

Maryland

1,355

7,098

28,963

7,746

46,632

18%

62%

17%

Massachusetts

1,409

8,712

22,237

10,250

46,743

22%

48%

22%

Michigan

540

5,342

51,046

9,681

67,485

9%

76%

14%

Minnesota

611

5,888

26,586

5,716

44,324

15%

60%

13%

Mississippi

1,844

1,418

35,520

5,888

44,670

7%

80%

13%

Missouri

2,286

2,618

28,409

4,379

38,395

13%

74%

11%

Montana

579

1,237

12,310

1,769

16,313

11%

75%

11%

Nebraska

930

2,219

9,912

4,183

19,015

17%

52%

22%

Nevada

219

1,724

7,623

1,301

11,150

17%

68%

12%

New Hampshire

884

2,772

8,971

1,713

15,805

23%

57%

11%

New Jersey

2,231

4,923

33,813

27,300

70,147

10%

48%

39%

New Mexico

106

2,493

9,561

5,041

19,006

14%

50%

27%

6,970

38,926

126,112

56,060

233,805

20%

54%

Connecticut

Indiana

New York

24%
(continued)

B-8

Family Planning Annual Report: 2014 National Summary

Exhibit B–4.

Number and distribution of female family planning users, by effectiveness level of the
users’ primary method at exit from the encounter and state: 2014 (Source: FPAR Table 7)
(continued)

State

Highly
Highly
Effective
Effective
Permanent Reversible
Methods a Methods a

Moderately
Effective
Methods b

Less
Effective
Methods c

Total
At Risk d

Highly
Effective
Methods a

Moderately
Effective
Methods b

Less
Effective
Methods c

North Carolina

610

18,665

57,669

11,116

99,304

19%

58%

11%

North Dakota

310

594

5,793

783

7,676

12%

75%

10%

2,847

5,430

36,524

8,691

55,147

15%

66%

16%

424

5,789

28,967

5,500

41,567

15%

70%

13%

Ohio
Oklahoma
Oregon

1,263

9,452

31,478

5,794

49,339

22%

64%

12%

Pennsylvania

6,492

11,512

87,680

48,357

170,723

11%

51%

28%

Rhode Island

2,601

3,006

6,687

3,995

19,378

29%

35%

21%

South Carolina

1,473

6,413

52,205

12,372

73,600

11%

71%

17%

South Dakota

74

300

5,086

350

5,882

6%

86%

6%

424

9,339

56,696

8,973

77,492

13%

73%

12%

4,185

11,866

46,636

21,259

94,711

17%

49%

22%

Utah

307

2,688

21,138

2,665

27,048

11%

78%

10%

Vermont

272

1,242

4,102

629

6,860

22%

60%

9%

Virginia

490

4,932

48,712

4,015

61,035

9%

80%

7%

1,257

10,391

46,677

7,753

67,126

17%

70%

12%

West Virginia

717

2,266

34,459

5,100

42,846

7%

80%

12%

Wisconsin

344

3,130

20,659

6,208

32,407

11%

64%

19%

Wyoming

369

487

5,332

712

6,957

12%

77%

10%

18

95

758

10

881

13%

86%

1%

1

58

560

34

663

9%

84%

5%

114

665

1,912

634

3,379

23%

57%

19%

5

0

154

35

202

2%

76%

17%

Puerto Rico

59

448

14,322

3,745

18,707

3%

77%

20%

Republic of the
Marshall Islands

54

285

423

127

914

37%

46%

14%

Republic of Palau

40

208

1,012

43

1,303

19%

78%

3%

U.S. Virgin Islands

177

97

1,297

1,119

2,742

10%

47%

41%

82,330

405,310

1,934,647

668,639

3,259,232

15%

59%

21%

2%–37%

35%–86%

1%–41%

Tennessee
Texas

Washington

Territories & FAS
American Samoa
Comm. of the Northern
Mariana Islands
Federated States of
Micronesia
Guam

Total Users
Range

FAS=Freely Associated States.
Note: Percentages (row) do not sum to 100% because the table does not show the percentages for female users relying on abstinence or
whose method is unknown/not reported. Because of combined FPAR reporting categories (e.g., FAM and LAM, diaphragm and cervical
cap, or withdrawal and other), the FPAR data may vary slightly from the three method-effectiveness categories (see reference note 10).
a
Highly effective permanent methods include female sterilization and vasectomy (male sterilization). Highly effective reversible methods
include implants and intrauterine devices/systems.
b
Moderately effective methods include injectable contraception, vaginal ring, contraceptive patch, pills, and diaphragm or cervical cap.
c
Less-effective methods include male condoms, female condoms, the sponge, withdrawal, fertility-based awareness or lactational
amenorrhea methods, and spermicides.
d
Female users at risk of unintended pregnancy exclude users who are pregnant, seeking pregnancy, or not using a method for “other”
reasons (e.g., sterile).

Family Planning Annual Report: 2014 National Summary

B-9

Exhibit B–5.

Number and percentage of female family planning users under 25 years who were tested
for chlamydia, by state: 2014 (Source: FPAR Table 11)

State
Alabama

Female Users
Under 25 Years
Tested for Chlamydia

Female Users
Under 25 Years

% of Female Users
Under 25 Years
Tested for Chlamydia

38,665

49,291

78%

Alaska

2,230

3,685

61%

Arizona

11,545

13,821

84%

Arkansas

19,287

26,431

73%

California

310,232

443,556

70%

Colorado

15,110

24,629

61%

Connecticut

10,074

15,968

63%

Delaware

5,368

7,408

72%

District of Columbia

7,139

12,063

59%

Florida

26,469

68,943

38%

Georgia

16,729

41,754

40%

Hawaii

3,877

8,012

48%

Idaho

2,959

7,915

37%

Illinois

21,805

41,112

53%

Indiana

7,753

13,797

56%

13,847

22,475

62%

6,391

10,650

60%

Kentucky

12,708

28,361

45%

Louisiana

13,712

17,358

79%

4,879

9,809

50%

Maryland

13,052

26,686

49%

Massachusetts

14,202

25,660

55%

Michigan

15,874

38,867

41%

Minnesota

15,267

27,228

56%

Mississippi

16,076

25,277

64%

Missouri

12,697

23,231

55%

Montana

5,351

10,377

52%

Nebraska

5,729

9,000

64%

Nevada

4,204

5,306

79%

New Hampshire

4,091

8,185

50%

New Jersey

17,470

32,493

54%

New Mexico

5,617

11,761

48%

73,930

124,830

59%

Iowa
Kansas

Maine

New York

(continued)

B-10

Family Planning Annual Report: 2014 National Summary

Exhibit B–5.

Number and percentage of female family planning users under 25 years who were tested
for chlamydia, by state: 2014 (Source: FPAR Table 11) (continued)

State

Female Users
Under 25 Years
Tested for Chlamydia

Female Users
Under 25 Years

% of Female Users
Under 25 Years
Tested for Chlamydia

North Carolina

15,208

44,062

35%

North Dakota

2,490

4,303

58%

Ohio

18,670

34,050

55%

Oklahoma

17,608

29,473

60%

Oregon

12,362

25,156

49%

Pennsylvania

46,112

91,825

50%

Rhode Island

4,645

10,463

44%

South Carolina

21,503

40,264

53%

South Dakota

1,802

3,729

48%

Tennessee

20,860

47,132

44%

Texas

19,332

39,150

49%

Utah

6,461

16,838

38%

Vermont

2,394

3,959

60%

Virginia

16,978

26,688

64%

Washington

25,634

39,305

65%

West Virginia

12,938

29,398

44%

Wisconsin

6,971

18,797

37%

Wyoming

1,898

4,237

45%

Territories & FAS
American Samoa

202

396

51%

Comm. of the Northern Mariana
Islands

17

350

5%

Federated States of Micronesia

355

1,394

25%

91

199

46%

1,512

9,357

16%

61

383

16%

Republic of Palau

119

473

25%

U.S. Virgin Islands

912

1,262

72%

1,011,474

1,758,582

58%

Guam
Puerto Rico
Republic of the Marshall Islands

Total Users
Range

5%–84%

FAS=Freely Associated States.

Family Planning Annual Report: 2014 National Summary

B-11

This page intentionally left blank.

B-12

Family Planning Annual Report: 2014 National Summary

Appendix C
Field and Methodological Notes

INTRODUCTION
This appendix presents additional information about the 2014 FPAR, including issues RTI
identified during data validation and relevant table-specific notes from grantees and Health
and Human Services (HHS) Regional Project Officers. The notes are organized according to
the FPAR reporting table to which they apply.

FPAR COVER SHEET: GRANTEE PROFILE
Subrecipients—Of the 92 grantees that were active in both 2013 and 2014, 66 reported no
change in the number of subrecipients, 19 reported a decrease, and 7 reported an increase.
Several grantees attributed the decrease in subrecipients to their withdrawal from Title X
participation, an error in the number of subrecipients reported in 2013, agency mergers, and
agency closures.
Service Sites—Of the 92 grantees active in both 2013 and 2014, 48 reported no change in the
number of service sites, 28 reported a decrease, and 16 reported an increase. Several grantees
attributed the decrease in number of sites to one or more of the following reasons: site
closures or consolidations, withdrawal from Title X participation, an error in the number of
service sites reported in 2013, reduced funding, and loss of funding from a specific source
(e.g., state funding). The addition of new subrecipients was the reason cited for the increase in
number of service sites.
Reporting Period—Seven grantees in Regions I, IV, IX, and X reported data for a reporting
period that was less than 12 months.

FPAR TABLE 1: USERS BY AGE AND SEX
Of the 92 grantees operating in both 2013 and 2014, 70 reported a decrease and 22 reported
an increase in the number of family planning users.
Several grantees attributed the decrease in number of users to one or more of the following
reasons: reduced funding from Title X or other sources (e.g., Infertility Prevention Project
[IPP] and HIV prevention grants); reduced access or efficiency because of site closures, site
or subrecipient withdrawal from Title X participation, electronic health record (EHR)
implementation or transition, inclement weather, or staffing shortages (e.g., furlough, medical
leave, and clinical services provider recruitment or retention); a reduced number of
encounters because of adherence to screening guidelines or increased use of long-acting
reversible contraception (LARC); increased ability of newly insured clients to seek care from
other providers (e.g., federally qualified health centers [FQHCs] or private practitioners);
more accurate collection of encounter data; and a reduction in teenage users because of
abstinence messaging in schools.
Several grantees attributed the increase in number of users to one or more of the following
reasons: the addition of a new subrecipient, integration of family planning services with
C-2

Family Planning Annual Report: 2014 National Summary

primary health care, increased outreach to males and teens, successful staff recruitment,
legislation permitting expedited partner therapy, and improved data collection and reporting.

FPAR TABLE 2: FEMALE USERS BY ETHNICITY AND RACE
Female Hispanic or Latino users accounted for a disproportionate share of female users with
an unknown race. Of the 16% of total female users for whom race was unknown or not
reported in 2014, 70% self-identified as Hispanic or Latino.
Reasons cited by grantees for the increase or continued high percentage of female users with
unknown race or ethnicity include client confusion about or refusal to report race, loss of data
during EHR implementation or transition (e.g., EHR system “glitches” or optional race field),
data transmission errors, EHR systems or data collection forms that allow clients to refuse to
report race or ethnicity or to report “Other” race, and staff failure to collect data. Reasons
cited for a decrease in the percentage of female users with unknown race include an improved
workflow resulting in better capture of ethnicity and race data, reprogramming of the EHR,
monthly data monitoring and corrections, and staff training.

FPAR Table 3: MALE USERS BY ETHNICITY AND RACE
Male Hispanic or Latino users accounted for a disproportionate share of male users with an
unknown race. Of the 19% of total male users for whom race was unknown or not reported in
2014, 66% identified as Hispanic or Latino.
Reasons cited by grantees for an increase in or continued high percentage of male users with
unknown race include client confusion about or refusal to report race, data transmission
errors, loss of data during EHR implementation or transition (e.g., “glitches” or optional race
field), data transmission errors, EHR systems or data collection forms that allow clients to
refuse to report race or ethnicity or to report “Other” race, data entry errors, and staff failure
to collect data. Reasons cited for a decrease in the percentage of male users with unknown
race include an improved workflow resulting in better capture of ethnicity and race data,
reprogramming of the EHR, monthly data monitoring and corrections, and staff training.

FPAR TABLE 4: USERS BY INCOME LEVEL
Unknown/not reported income status—Several grantees attributed the high or increased
number of family planning users with unknown or not reported income to problems with data
collection, including client (e.g., full-fee or insured clients) refusal to report income data;
failure of sites to collect income data for all or specific client subgroups (e.g., full-fee,
insured, and teens); loss of income data during EHR system transitions; failure to collect the
data because of an optional income field in the EHR system; and system-related processing
errors. Several other grantees attributed the decrease in number of family planning users with
unknown or not reported income to improved data collection or data quality monitoring and
staff training.
Family Planning Annual Report: 2014 National Summary

C-3

FPAR TABLE 5: USERS BY PRINCIPAL HEALTH INSURANCE COVERAGE
STATUS
Of the 92 grantees operating in both 2013 and 2014, 78 reported an increase in the percentage
of users with health insurance, 12 reported a decrease, and 2 reported no change. Several
grantees attributed the increase in the number or percentage of family planning users with
health insurance to one or more of the following reasons: an increase in newly insured clients
who gained access to affordable private or public (Medicaid in expansion states) health
insurance because of the ACA and increased enrollment efforts by site staff, improved
collection of health insurance data, an increase in the number of higher-income clients who
are insured, and increased efforts to bill private insurance.
Unknown/not reported health insurance status—Several grantees attributed the high or
increased number of family planning users with unknown or not reported health insurance
coverage status to problems extracting accurate data from EHRs, correctly reporting clients
who do not report health insurance status as unknown or not reported health insurance instead
of uninsured, errors in transmitting health insurance status data, and failure to collect or
record health insurance status. One grantee attributed the decreased number of family
planning users with unknown or not reported principal health insurance coverage status to
correction of an error in the electronic practice management system.

FPAR TABLE 6: USERS WITH LIMITED ENGLISH PROFICIENCY (LEP)
Of the 92 grantees operating in both 2013 and 2014, 62 reported a decrease in the number of
LEP users, 38 reported a decrease in the percentage of users who are LEP, and 2 reported no
change in either the number or percentage of LEP users. Several grantees attributed the
decrease in LEP users to a decline in users overall, a decline in LEP users, and improved data
collection.
Of the 92 grantees operating in both 2013 and 2014, 28 reported an increase in the number of
LEP users, 52 reported an increase in the percentage of LEP users, and 2 reported no change.
Several grantees attributed the increase in LEP users to one or more of the following reasons:
improved data collection resulting from modifications to EHR systems, changing
demographic characteristics of client population, and increased outreach to minority
communities.
Unknown/not reported LEP status—Several grantees reported limitations of their data
systems to collect “unknown/not reported” LEP status because the systems only capture LEP
status (yes or no). Some grantees noted that LEP status was added to their data systems
during the reporting period and that LEP figures will be more accurate in 2015.

FPAR TABLE 7: FEMALE USERS BY PRIMARY CONTRACEPTIVE METHOD
Hormonal injection users—Twelve grantees in seven regions (I, III, IV, V, VI, VIII, and IX)
reported a total of 117 female users who relied on 1-month hormonal injections as their

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Family Planning Annual Report: 2014 National Summary

primary method. One-month hormonal injection users accounted for 0.02% of the 611,618
hormonal injection users reported in 2014.
Sterilization among users under 20—Grantees that reported female users under 20 relying
on female sterilization as their primary method confirmed that these female users were
sterilized prior to their seeking services at the Title X service site.
Vasectomy among users under 18—Grantees that reported five female users under 18
relying on vasectomy as their primary method confirmed that these female users received
noncoercion counseling.
Unknown/not reported primary contraceptive method—Several grantees attributed the
high or increased number of female users with an unknown primary method to staff turnover;
misreporting of clients with same sex partners; problems with data systems or data collection
procedures, including EHR implementation or transition and EHR design (e.g., drop-down
menu); and failure to collect primary method data for specific user subgroups (e.g., LEP
clients or clients seeking emergency contraception) or encounters (e.g., nonclinical
encounters). Two grantees attributed the low or decreased number of female users with an
unknown primary method to improved data collection, EHR systems that did not allow an
“unknown or not reported” method category, and staff training.

FPAR TABLE 8: MALE USERS BY PRIMARY CONTRACEPTIVE METHOD
Unknown/not reported primary contraceptive method—Several grantees attributed the
high or increased number of male users with an unknown primary method to one or more of
the following reasons: clients refused a method, data entry or coding error, inconsistent
collection of primary method data, lack of a field or poorly defined field in the EHR system to
record primary method at exit, data collection error during EHR implementation, lack of
oversight due to management turnover, failure to require primary method at exit for male
clients, loss of data during transmission, and staff turnover. Several other grantees attributed
the decline in number of male users with an unknown primary method to improved data
collection, staff training, increased patient education, and improved workflow.

FPAR TABLE 9: CERVICAL CANCER SCREENING ACTIVITIES
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 67 reported a decrease in
the percentage of female users who received a Pap test. Several grantees attributed the decline
in cervical cancer screening to adherence to cervical cancer screening guidelines and a
decline in the number of female users.
In contrast, 25 grantees reported an increase in the percentage of female users tested. Several
grantees attributed the increase in cervical cancer screening to one or more of the following
reasons: improved reporting, increased patient volume, better documentation, patients
returning for follow-up test based on guidelines, and increased emphasis on preventive health
screenings.

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FPAR TABLE 10: CLINICAL BREAST EXAMS AND REFERRALS
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 62 reported a decrease in
the percentage of female users who received a CBE and 69 reported a decrease in the number
of females examined. Several grantees attributed the decrease in CBEs to better adherence to
breast cancer screening guidelines, a decline in the number of female clients, a decrease in the
frequency of clients receiving other physical exams or tests during which a CBE might be
performed (e.g., Pap tests or comprehensive physical exams), improved data collection, and
changes in protocol.
In contrast, 30 grantees reported an increase in the percentage of female users examined and
23 reported an increase in the number examined. Several grantees attributed the increase in
CBEs performed to one or more of the following reasons: improved data collection, including
correction of an error in the EHR system and EHR implementation; an increase in new
clients; the addition of a physician; and an increased emphasis on preventive health
screenings.
Finally, a few grantees noted that the number of reported CBEs was an estimate based on the
comprehensive/global billing code for a complete physical exam.

FPAR TABLE 11: USERS TESTED FOR CHLAMYDIA BY AGE AND SEX
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 58 reported a decrease in
the percentage of female users under 25 tested for chlamydia and 74 reported a decrease in
the number tested. Several grantees attributed the decrease in chlamydia testing to one or
more of the following reasons: a decrease in patient volume, decreased funding or loss of
targeted funding (e.g., IPP), difficulty extracting testing data from the EHR, implementation
of a flat-fee STD testing program (tests not reported in FPAR), adherence to screening
guidelines, delays in obtaining test kits from the state, site closures, and changes in clients’
care-seeking behavior.
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 34 reported an increase in
the percentage of female users under 25 tested for chlamydia and 18 reported an increase in
the number tested. Several grantees attributed the increase in chlamydia testing to one or
more of the following reasons: availability of targeted funding (IPP), increased marketing to
males, an increase in patient volume or service sites, chlamydia outbreaks, increased
adherence to screening guidelines, and (male) partner testing.
Finally, of the 92 grantees that submitted an FPAR in both 2013 and 2014, 45 grantees
reported an increase and 42 reported a decrease in the percentage of male users under 25
tested, while 32 reported an increase and 56 reported a decrease in the number tested.

FPAR TABLE 12: GONORRHEA, SYPHILIS, AND HIV TESTING BY SEX
Gonorrhea Tests—Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 50
reported an increase in the number of gonorrhea tests per female user and 46 grantees
reported an increase in the number of tests per male user. Reasons cited for the increase in
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gonorrhea testing include an increased use of the combined chlamydia and gonorrhea test, an
increased number of users or high-risk users, additional funding to support testing,
implementation of new screening initiatives (e.g., routine screening), high prevalence or an
outbreak in the service area, increased promotion of STD testing services, collection and
testing of multiple specimens from the same client, a change in reimbursement for STD tests,
the addition of new service sites, and improved data collection/reporting.
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 42 reported a decrease in
the number of gonorrhea tests performed per female user and 42 reported a decrease in the
number of tests per male user. Reasons cited for the decrease in gonorrhea testing include loss
of funding, loss of providers, site closures, a decrease in the number of users, and loss of
laboratory equipment.
Syphilis Tests—Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 55
reported an increase in the number of syphilis tests per female user and 57 reported an
increase in the number of tests per male user. Reasons cited for the increase in syphilis testing
include high prevalence or an outbreak in the service area, patient request, extended service
hours, an increase in the number of service sites or users, an increase in the number of highrisk users, implementation of routine testing for men, a change in reimbursement for STD
tests, and improved data collection/reporting.
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 37 reported a decrease in
the number of syphilis tests per female user and 31 reported a decrease in the number of
syphilis tests per male user. Reasons cited for the decrease in syphilis testing include a decline
in users, low prevalence in the service area, a change in reimbursement for STD-related labs,
loss of funding, and more accurate data collection/reporting.
Confidential HIV Tests—Of the 92 grantees that submitted an FPAR in both 2013 and 2014,
41 reported an increase in the number of confidential HIV tests per female user and 45
reported an increase in the number of confidential HIV tests per male user. Reasons cited for
the increase in confidential HIV testing include increased compliance with CDC testing
guidelines, implementation of opt-out testing, increased HIV incidence in the service area,
availability of free rapid HIV tests, the integration of HIV testing services into family
planning, availability of targeted funding for HIV (e.g., CDC, Title X), an increase in the
number of male users, additional service sites, improved collaboration with other agencies,
off-site testing, and improved data collection/reporting.
Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 51 reported a decrease in
the number of confidential HIV tests per female user and 42 reported a decrease in the
number of confidential HIV tests per male user. Reasons cited for the decrease in confidential
HIV tests include a decrease in the number of users, loss of dedicated funding, problems or
improvements in data collection/reporting, and fewer rapid HIV testing kits.
Positive Confidential HIV Tests—Of the 92 grantees that submitted an FPAR in both 2013
and 2014, 37 reported an increase in the number of positive confidential HIV tests per 1,000
tests performed, 27 reported a decrease, 26 reported no change (ratio was zero in both years),
and 2 performed no confidential HIV tests. Reasons cited for the increase in number of
positive confidential HIV tests include increased testing of high-risk male clients,
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participation in a Title X HIV testing intervention, and an error in reporting by one
subrecipient. One grantee attributed the decrease to changes in data collection methods.
General Comments—Several grantees cited reasons for an increase or decrease in STD
testing that were not specific to the type of test. Reasons for the increase in STD testing
include health insurance coverage for testing, funding from a Medicaid family planning
eligibility expansion, promotion of STD testing services, improved data collection, closure of
state STD clinics, enhanced referrals from community organizations, colocating a Title X
service site and needle exchange program, an increase in number of clients, extended
operating hours, availability of walk-in appointments, increased STD rates or outbreaks in the
service area, and increased availability of local laboratory services. An increase in male STD
testing was attributed to encouraging at-risk males to be tested, offering repeat testing during
the reporting period, offering flat-rate testing, and testing multiple specimens for the same
individual (e.g., urine, oral, urethral, or anal). Grantees attributed the decline in general STD
testing to a decrease in clients, site closures, improved data collection, improved compliance
with CDC testing guidelines, changes in reimbursement for STD tests, less funding for STD
testing activities, offer of flat-rate STD testing (not reported in FPAR), and difficulty
obtaining testing supplies.

FPAR TABLE 13: FAMILY PLANNING ENCOUNTERS AND STAFFING
Clinical Services Providers—Of the 92 grantees that submitted an FPAR in both 2013 and
2014, 49 reported a decrease in the total number of FTE CSPs delivering Title X-funded
services, 30 reported an increase, and 13 reported no change. By type of CSP, the changes in
number of FTEs were as follows:

▪ Physicians—37 grantees reported a decrease in physician CSP FTEs, 26 reported an
increase, and 29 reported no change.

▪ Midlevel Clinicians—42 grantees reported a decrease in midlevel clinician CSP FTEs,
33 reported an increase, and 17 reported no change.

▪ Other CSPs—72 grantees reported zero Other CSP FTEs in both years, 11 reported a
decrease, 5 reported an increase, and 4 reported no change.

Several grantees attributed the increase in CSP FTEs to the addition of new sites and more
staff or improved collection/reporting of FTE data. Reasons cited for the decrease in CSP
FTEs include decreased funding, site closures, reduced clinic hours, a decline in users, staff
retirement, difficulty retaining or recruiting staff, more efficient use of other services
providers, and more accurate collection/reporting of FTE data.
Encounters—Of the 92 grantees that submitted an FPAR in both 2013 and 2014, 74 reported
a decrease in the number of total encounters, and 61 reported a decrease in the number of
encounters with a CSP. Several grantees attributed the decrease in family planning encounters
to a decline in users, work slowdowns because of EHR implementation, changes in methodsupply policies or use of methods that require fewer visits (e.g., LARCs), staffing shortages,
decreased funding, site closures, reduced operating hours, and data system problems.

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Family Planning Annual Report: 2014 National Summary

Eighteen of 92 grantees reported an increase in total encounters, and 31 reported an increase
in the number of encounters with a CSP. Several grantees attributed the increase in the
number of encounters with a CSP to changes in service policy, more accurate collection of
data on the type of provider rendering care, and an increase in CSP FTEs. Reasons for the
increase in CSP FTEs include filling vacancies, adding new service sites, and more accurately
collecting and reporting FTE data.

FPAR TABLE 14: REVENUE REPORT
Title X revenue (row 1)—All Regions—Title X revenue includes 2014 cash receipts or
drawdown amounts from all family planning service grants, including supplemental awards
(e.g., HIV and health information technology).
Medicaid revenue (row 3a)—All Regions—Medicaid revenue includes revenue from state
Medicaid family planning eligibility expansions in 29 states in all 10 HHS regions. The 29
expansion states, by region, are the following:
Region I—Connecticut, New Hampshire, and Rhode Island
Region II—New York
Region III—Maryland, Pennsylvania, and Virginia
Region IV—Alabama, Florida, Georgia, North Carolina, Mississippi, and South Carolina
Region V—Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
Region VI—Louisiana, New Mexico, and Oklahoma
Region VII—Iowa and Missouri
Region VIII—Montana and Wyoming
Region IX—California
Region X—Oregon and Washington
Other revenue (rows 12 through 16)—All Regions—An illustrative list of “other” revenue
sources reported in rows 12 through 16 includes 340B rebates; agency contributions; state
STD programs (formerly IPP); bad debt recoupment; business and community contributions;
cash; CDC; CDC (breast, cervical, and colon health); CDC (IPP); charity care; chlamydia
project funds; Community Health Network grant; Community Service Block Grant;
consultation fees; contraceptives; delayed payment from previous grant; donations (private or
client); earned income and special funds; education revenue; Eskenazi Health (contribution
toward patient fee); foundation and private grants; grantee general fund; grantee subsidy;
Healthy Women/Healthy Babies program; HealthyWoman program; HHS ACA Navigator
grant; HIV or STD prevention programs; insurance exchange; interest income; Kansas
Statewide Farmworker Health Program; local grants; Massachusetts Alliance on Teen
Pregnancy; Medicaid Meaningful Use; medical records; Merck 340b refund; mileage
reimbursement; miscellaneous; MPA Grant; nonclient donations; noninsurance; other
(donations, grants, local support, supplies, contracts, and travel); other federal grants (e.g.,
Ryan White, Personal Responsibility Education Program) or revenue; other nonfederal grants
Family Planning Annual Report: 2014 National Summary

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and contracts; pharmacy reimbursements, discounts, or return refunds; PPFA Breast Health
Program; preceptor honorarium; Project Connect grant; Refugee Health Program; rental
income; restricted donations and gifts; revenue recovery; School Base Health program; Show
Me Healthy Women; St. James PHO; state grant-in-aid; STD 106 Federal Grant; STD
program funding (state and state pass-through); STD program funding and income;
subcontracts; subrecipient contraceptive purchases; subrecipient contributions; tobacco
settlement; travel reimbursements; Trilogy; UNFPA; United Way; vendor reimbursement;
Women over 40; and HIV Prevention Center.
Total revenue (row 18)—All Regions—Of the 92 grantees that submitted an FPAR in both
2013 and 2014, 49 reported a decrease in total revenue and 43 reported an increase.

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Office of Population Affairs
Office of the Assistant Secretary for Health
U.S. Department of Health and Human Services
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