Sexual behavior, reproductive health and contraceptive use among opioid-maintained women

Abstract

Objectives: Approximately 40% of US adults who are currently receiving opioid maintenance therapy are women of reproductive age, among whom 77% report a history of unintended pregnancy. The aims of the current study are to characterize the sexual behaviors and reproductive health of opioid-maintained women and identify factors that may influence initiation and use of contraceptives. Methods: We conducted a retrospective secondary analysis of data from 70 opioid-maintained women aged 20–44 who were screened for clinical trials on prescription contraception interventions. Results: Fifty-eight percent of women reported one sexual partner in the past year, 23% reported two and 19% reported three or more. The prevalence of self-reported lifetime amenorrhea was high (68%), although the majority of women currently reported regular periods. Despite 92% endorsing the importance of avoiding pregnancy, only 28% had used any contraceptives in the past 3 months. Moreover, 80% of women indicated they had all of the information necessary to avoid an unplanned pregnancy, but the majority reported little or no knowledge about pills, the injectable or IUDs (64%, 77% and 91%, respectively). Women identified effectiveness and ease of use as factors that would influence their contraceptive method choice the most. Conclusions: Although the majority of opioid-maintained women report no current pregnancy intention, these results may provide insight into why they do not typically use highly effective contraceptives. Reasons for lack of use may include misperceptions about their fertility and lack of knowledge about different types of methods. These results have implications for increasing the use of more effective contraceptives.