Reproductive Health Needs Among Drug Treatment Clients

Abstract

INTRODUCTION: Substance users are at increased risk of unintended pregnancy and sexually transmitted infections and human immunodeficiency virus (HIV). The objective of this study is to explore the prevalence of contraceptive use and reproductive health care uptake among drug treatment clients. METHODS: Between August 2012 and October 2013, clients of four Baltimore city drug treatment centers completed a one-time survey adapted from the National Survey of Family Growth. χ2 tests and logistic regression assessed associations between demographic variables and contraception use. RESULTS: A total of 95 men and 54 women participated. Most were younger than 50 years (74% women; 72% men), sexually active (68% women; 85% men), and did not desire pregnancy (74% women; 63% men). However, many did not use contraception most of the time (54% women; 39% men) with few women reporting use of a nonbarrier method (7%). Although condoms were the most common method (35% women; 45% men), only one fourth (28% women; 26% men) reported consistent use. Most women (70%) completed an obstetrics–gynecology appointment in the past year, but fewer had received an annual examination (37%), Pap test (53%), mammogram (20%), or HIV (59%) or sexually transmitted infection testing (45%). Contraception use among women was not associated with age (P=.7), parity (P=.7), self-rated health quality (P=.4), HIV (P=1.0), or hepatitis C virus status (P=1.0). Most (74% women; 57% men) stated they would definitely or maybe use family planning services at their treatment site if available. CONCLUSIONS: Drug treatment clients have high unmet reproductive health needs. Tailored family planning interventions are needed and should be incorporated into substance use programs.