Departments of Obstetrics, Gynecology, and Reproductive Sciences and Psychological Science, University of Vermont, Burlington, Vermont; the Department of Sociology, University of Wisconsin-Madison, Madison, Wisconsin; the Department of Obstetrics and Gynecology and the School of Nursing, University of Michigan Ann Arbor, Michigan; and the Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Obstet Gynecol. 2020 Feb;135(2):361-369. doi: 10.1097/AOG.0000000000003666.
To evaluate the sexual and reproductive health characteristics of women in treatment for opioid use disorder in Michigan and explore services provided and desired.
We conducted a cross-sectional study of female patients aged 18-50 years who accessed opioid use disorder treatment at 22 randomly selected facilities in Michigan from December 2015 to May 2017. Computer-assisted self-interviews were completed using online survey management software to assess prior substance use and use disorder treatment, sexual and reproductive health history, and sexual and reproductive health services received in the previous 12 months through a treatment program, and desire for and barriers to sexual and reproductive health services within substance use disorder treatment. Descriptive statistics were calculated.
The final sample consisted of 260 participants. About half (51.5%) had ever had an abnormal Pap test result, and 57.3% had ever tested positive for a sexually transmitted infection. Unintended pregnancy was common (61.2%), as was substance use during pregnancy (74.2%). Nearly half (46.5%) were not currently using a method of contraception, and only 28.5% were using a highly effective method. Common barriers to accessing reproductive health services included fear of being treated poorly or judged because of substance use, fear of child protective services, and structural barriers such as cost and lack of transportation. Most participants (80.4%) indicated interest in receiving sexual and reproductive health services on site or by referral from their substance use disorder treatment programs.
Women in treatment for opioid use disorder in Michigan have high rates of adverse sexual and reproductive health experiences and face barriers to accessing care.
评估密歇根州接受阿片类药物使用障碍治疗的女性的性健康和生殖健康特征，并探讨所提供和期望的服务。
我们对 2015 年 12 月至 2017 年 5 月在密歇根州 22 个随机选定的设施接受阿片类药物使用障碍治疗的年龄在 18-50 岁的女性患者进行了一项横断面研究。使用在线调查管理软件完成计算机辅助自我访谈，以评估既往物质使用和物质使用障碍治疗、性健康和生殖健康史，以及在过去 12 个月内通过治疗计划获得的性健康和生殖健康服务，以及对物质使用障碍治疗中性健康和生殖健康服务的需求和障碍。计算描述性统计数据。
最终样本由 260 名参与者组成。约一半（51.5%）曾有过异常巴氏试验结果，57.3%曾有过性传播感染阳性结果。意外怀孕很常见（61.2%），怀孕期间物质使用也很常见（74.2%）。近一半（46.5%）目前未使用避孕方法，只有 28.5%使用高效避孕方法。获得生殖健康服务的常见障碍包括因物质使用而担心受到不良对待或评判、担心儿童保护服务以及成本和缺乏交通工具等结构性障碍。大多数参与者（80.4%）表示有兴趣在现场或通过其物质使用障碍治疗计划转介接受性健康和生殖健康服务。
密歇根州接受阿片类药物使用障碍治疗的女性不良性健康和生殖健康体验发生率高，且在获得护理方面面临障碍。
