AIMS:
To report
on a survey of sexual health service needs among substance-misusing women
attending a substance misuse service.
BACKGROUND:
Substance-misusing
women carry a disproportionate burden of sexual ill health, yet the range and
frequency of their sexual health risks, morbidities and service engagement are
poorly understood.
DESIGN:
A
cross-sectional survey of a convenience sample of substance-misusing women
attending a substance misuse service.
METHODS:
From 4
April 2010-17 September 2010, substance-misusing women in Hastings & Ore,
UK, were invited to complete a paper questionnaire addressing: drug use;
cervical cytology, sexually transmitted infection and HIV screening history;
pregnancy history, perceived pregnancy risk and contraceptive advice and
supply; sexual activity and assault. Of 91 respondents, 77 attended local drug
treatment services - results comprise analysis of this sub-sample.
RESULTS:
The study
sample was characterized by long-term opioid and crack cocaine use. Of 53%
sexually active in the previous 4 weeks, 66% perceived they had experienced
sexual intercourse that could lead to pregnancy during that time. Fifty-five
per cent had been forced to have sex against their will during their lifetime.
High rates of sexually transmitted infections, pregnancy termination,
miscarriage and abnormal cervical cytology were reported.
CONCLUSIONS:
Findings
indicate the need to recognize the breadth of elevated sexual health risks and
morbidities experienced by substance-misusing women with long-term opioid/crack
use, including those not identifying as intravenous drug users. Poor recall of
drop-in and appointment times, reluctance to disclose substance misuse and
likelihood of previous sexual assault present significant challenges to nurses,
who must take a sensitive, opportunistic approach to referral and provision of
sexual health interventions to substance-misusing women.
1Centre for Health Research, University of Brighton,
Falmer, UK.
J Adv Nurs. 2014
Dec;70(12):2861-70. doi: 10.1111/jan.12442. Epub 2014 May 7.
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