Black Kirsten I, Stephens Christine, Haber Paul S, Lintzeris Nicholas
Discipline of Obstetrics, Gynaecology and Neonatology, Central Clinical School, Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW, Australia.
Aust N Z J Obstet Gynaecol. 2012 Apr;52(2):146-50. doi: 10.1111/j.1479-828X.2012.01413.x. Epub 2012 Feb 15.
At an international level, there are calls for a greater focus on women and harm reduction in recognition that female drug users have a unique set of issues that are not routinely assessed in drug treatment programs.
To assess the pregnancy history, current pregnancy risk and contraceptive use of nonpregnant women attending opioid treatment programs (OTPs).
This study involved a structured questionnaire survey of 204 women attending outpatient OTP services within the Sydney South West Area Health Service.
Two hundred and four women of 302 (67.5%) enroled in OTPs at the time completed surveys. Key findings were high pregnancy rates, with 28.9% of women reporting six or more pregnancies, high rates of adverse pregnancy outcomes (miscarriage, termination and stillbirth) compared with national data and poor uptake of contraception, with only 54.7% of sexually active women not wanting to get pregnant using a method. Women expressed diverse preferences for the type and location of women's health services they felt would meet their needs.
Women in OTP clinics have unaddressed reproductive health issues, particularly around contraception. Addressing these will potentially minimise the risk of material deprivation and social exclusion in these women and improve their well-being through greater control and choice over their fertility. Current women's health service provision in OTP programs involves referral to external services, but an integrated model of care may best address the unmet contraceptive needs of these women.
在国际层面，人们呼吁更加关注女性及减少伤害，因为认识到女性吸毒者有一系列独特问题，而这些问题在戒毒治疗项目中通常未得到评估。
评估参加阿片类药物治疗项目（OTP）的非妊娠女性的妊娠史、当前妊娠风险及避孕措施使用情况。
本研究对悉尼西南地区卫生服务中心门诊OTP服务的204名女性进行了结构化问卷调查。
当时参加OTP项目的302名女性中有204名（67.5%）完成了调查。主要发现包括妊娠率高，28.9%的女性报告有6次或更多次妊娠；与全国数据相比，不良妊娠结局（流产、终止妊娠和死产）发生率高；避孕措施使用率低，只有54.7%有性行为且不想怀孕的女性采用了某种避孕方法。女性对她们认为能满足其需求的妇女健康服务类型和地点表达了不同偏好。
OTP诊所的女性存在未得到解决的生殖健康问题，尤其是在避孕方面。解决这些问题可能会将这些女性物质匮乏和社会排斥的风险降至最低，并通过对生育有更大的控制和选择权来改善她们的福祉。目前OTP项目中的妇女健康服务是将患者转诊至外部服务机构，但综合护理模式可能最能满足这些女性未得到满足的避孕需求。
