Reproductive Health Needs among Substance Use Disorder Treatment Clients
OBJECTIVES:
Individuals
with substance use disorders (SUDs) have unique reproductive health needs. The
aim of this study was to evaluate these needs and assess the acceptability of
family planning service delivery of SUD treatment clients.
METHODS:
Reproductive
health needs of drug treatment clients were assessed using a cross-sectional
anonymous survey in 4 treatment sites in Baltimore City, MD. Surveys were
distributed by staff. Contraceptives assessed included sterilization,
intrauterine devices, implants, injections, pills, patches, rings, condoms,
spermicide, withdrawal, and the rhythm method. Results are stratified by sex
and between those using and not using highly effective contraceptive methods.
RESULTS:
A total
of 115 women and 95 men completed the survey (80% younger than 50 years), with
39% of women and 54% of men reporting using condoms, but only 24% of women and
26% of men reporting consistent use. All other methods were used by less than
12% of the sample. Only 20% of sexually active women reported using a highly
reliable form of contraception and only 53% were using any form of
contraception at all. Contraceptive use correlated inversely with age, but did
not correlate with having had sexually transmitted infection testing or other
preventive health services. Although more than 90% of participants had access to
health care services in the past 3 years, 25% of women and 33% of men reported
difficulty accessing health care providers. The majority of respondents said
they would likely use family planning services if available at their SUD
treatment (83% of women and 58% of men).
CONCLUSIONS:
Men
and women in SUD treatment have unmet reproductive health needs. As SUD
treatment moves toward greater integration, the programmatic inclusion of
family planning services should be considered.
- 1Behavioral Health System Baltimore (MT); Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore MD (MT); School of Social Work, University of Haifa, Mount Carmel, Haifa, Israel (ML); University of Maryland School of Medicine, Baltimore MD (MBC); Department of Obstetrics and Gynecology University of North Carolina School of Medicine, Chapel Hill, NC (CEM).
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