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The overturn of Roe v. Wade beyond abortion: a snapshot of methotrexate accessibility for people with rheumatic and musculoskeletal diseases—a mixed methods study using Twitter data

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Abstract

In June 2022, the Supreme Court of the United States (US) overturned the right established in Roe v. Wade to terminate a pregnancy. Subsequently, some states passed abortion ban laws prohibiting the use of abortive methods, including methotrexate (MTX), which has been a cornerstone drug in rheumatology. We aimed to explore and analyze Twitter data to comprehend the short-term implications of the overturn on rheumatology care. We conducted a mixed methods study using social media (SoMe) data. Tweets publicly posted using “#Methotrexate or Methotrexate” were tracked. A combination of SoMe performance data with qualitative hashtag co-occurrence analysis and content analysis was conducted. A total of 5180 posts were generated and reached approximately 40 million users. Seventy-three percent of all publications came from the US. Females posted more than males. Additionally, the three pairs of hashtags with higher co-occurrence were: #roevswade, #abortionishealthcare, and #rheumatoidarthritis. From the content analysis, three main themes were generated: (i) violence against women, (ii) health policy without public health intelligence, and (iii) call for strategic alliances in favor of public health. The combination of biological sex and state of residence could condition the use of MTX. Men will be able to continue their treatment; however, women could lose continuity of it. Inequity in access to treatment is a political decision, just as it is to reproduce inequities and vulnerabilities through the actions taken. Not having access to MTX for rheumatic and musculoskeletal diseases (RMDs) is a critical issue that endangers the physical and mental health of people with RMDs.

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Data availability

The secondary data used in this study are public, published by users with public accounts on the SoMe platform Twitter (http://www.twitter.com).

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Acknowledgements

To María Piedad Rosario (medical librarian) for obtaining the full-texts to review the existing literature.

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Authors and Affiliations

  1. Instituto de Investigación Social y Sanitaria, Guayanilla, Puerto Rico

    José B. Negrón, Mary J. Rodriguez-Malavé, Christian O. Camacho & Carlos L. Malavé

  2. Mayagüez Medical Center, Mayagüez, Puerto Rico

    Christian O. Camacho

  3. Lifespan Physician Group, Inc, Providence, RI, USA

    Von M. Rodríguez-Guzmán

  4. Warren Alpert Medical School of Brown University, Providence, RI, USA

    Von M. Rodríguez-Guzmán

Authors
  1. José B. Negrón
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  2. Mary J. Rodriguez-Malavé
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  3. Christian O. Camacho
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  4. Carlos L. Malavé
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  5. Von M. Rodríguez-Guzmán
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Correspondence to José B. Negrón.

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Conflict of interest

No funding was received for the completion of this research project. However, JBN has received personal grants from the European Alliance of Associations for Rheumatology (EULAR) for activities unrelated to this work. Additionally, he is member of the Outcome Measures in Rheumatology (OMERACT). He has also worked as research fellow in the patient outcomes in longitudinal studies working group of OMERACT.

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Negrón, J.B., Rodriguez-Malavé, M.J., Camacho, C.O. et al. The overturn of Roe v. Wade beyond abortion: a snapshot of methotrexate accessibility for people with rheumatic and musculoskeletal diseases—a mixed methods study using Twitter data. Rheumatol Int 43, 2293–2301 (2023). https://doi.org/10.1007/s00296-023-05407-1

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