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药物辅助治疗阿片类药物使用障碍女性的生殖健康知识、态度和行为。

Reproductive Health Knowledge, Attitudes, and Behaviors Among Women Enrolled in Medication-Assisted Treatment for Opioid Use Disorder.

机构信息

1 Department of Public Health, University of Tennessee , Knoxville, Knoxville, Tennessee.

2 Knox County Health Department, Knoxville, Tennessee.

出版信息

J Womens Health (Larchmt). 2018 Oct;27(10):1215-1224. doi: 10.1089/jwh.2017.6564. Epub 2018 Jul 3.

Abstract

BACKGROUND

The lifetime prevalence of unintentional pregnancy among women enrolled in medically assisted treatment (MAT) for opioid use disorder (OUD) has been reported to exceed 80%. Consistent voluntary contraception use by women enrolled in MAT programs can reduce their risk of unintended pregnancies and increase their opportunity to plan the family size they want, yet little is understood about past and current contraception use or associated barriers and facilitators for this population of women.

MATERIALS AND METHODS

Women enrolled in treatment for OUD at two MAT clinics in East Tennessee were invited to participate in an anonymous survey about contraception. We describe the sociodemographic and health characteristics of the women (N = 287; estimated response rate of 81.0%), report on their contraception knowledge and attitudes, and assess how these characteristics are associated with current contraception use.

RESULTS

Most of the 287 women had been sexually active in the past 12 months (88%), were pregnant at least once (98%), and were insured (58%). Women having undergone bilateral tubal ligation had a greater average number of pregnancies (including those while on birth control), lower mean levels of depressed mood, and higher mean level of agreement that avoiding pregnancy now was important and that pregnant women should not use painkillers, compared to the women not using contraception.

CONCLUSIONS

Strategies to ensure all women enrolled in MAT for OUD have knowledge of effective contraception and affordable, quality contraception care that is responsive to their complicated and oftentimes traumatic histories are necessary to enhance the women's reproductive health.

摘要

背景

在接受阿片类药物使用障碍(OUD)医学辅助治疗(MAT)的女性中,意外怀孕的终身患病率据报道超过 80%。对于该人群来说,持续自愿使用避孕药具可以降低意外怀孕的风险,增加她们计划生育数量的机会,但对于该人群过去和当前的避孕措施使用情况以及相关的障碍和促进因素,我们知之甚少。

材料与方法

我们邀请了田纳西州东部两家 MAT 诊所接受 OUD 治疗的女性参与一项关于避孕的匿名调查。我们描述了这些女性的社会人口统计学和健康特征(N=287;估计响应率为 81.0%),报告了她们的避孕知识和态度,并评估了这些特征与当前避孕措施使用的关联。

结果

在过去的 12 个月中,大多数 287 名女性有过性行为(88%),至少怀孕过一次(98%),并且有保险(58%)。与未使用避孕措施的女性相比,接受双侧输卵管结扎术的女性怀孕次数(包括使用避孕药具期间的怀孕)更多,抑郁情绪评分更低,且更认同“现在避免怀孕很重要”和“孕妇不应使用止痛药”。

结论

为确保所有接受 OUD MAT 的女性都了解有效的避孕方法,并能获得负担得起且质量可靠的避孕护理,同时还能充分考虑到她们复杂且常常是创伤性的病史,这些都是增强女性生殖健康的必要措施。

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