Finanger Trine, Skråstad Ragnhild Bergene, Appleton Catherine, Hagemann Cecilie Therese
Clinic of Substance Use and Addiction Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
BMC Womens Health. 2025 May 24;25(1):252. doi: 10.1186/s12905-025-03794-0.
Women with substance use disorder (SUD) face a higher risk of sexual assault, abuse, cervical premalignant lesions, and unplanned pregnancy compared to the general female population. To meet the specific needs of this vulnerable group, we established a comprehensive gynecological service. The study aimed to describe the characteristics of women with SUD who accessed these services. Furthermore, we evaluated their cervical cytology and sexually transmitted infections (STIs) test results, preferred contraceptive methods, and the overall acceptability of the service.
We enrolled 48 women undergoing outpatient or inpatient treatment for SUD in the South-Trøndelag region of Norway in the study. Each women received a comprehensive gynecological anamnesis, including a history of sexual assault, followed by a gynecological examination at the outpatient clinic of the Department of Obstetrics and Gynecology. The examination included ThinPrep Tests and microbiological swabs. They were also offered contraception options, with an emphasis on Long Acting Reversible Contraceptives (LARC), at no cost. Participants provided feedback on the service immediately after their consultation and again six months later.
Nearly two-thirds (63%) of the women with a mean age 31.8, reported a history of sexual assault. One in three (33%) had cervical cytology or human pappilomavirus (HPV) test results necessitating treatment or follow-up, though no cases of sexually transmitted infections were found. Two thirds (66%) of eligible women chose LARC as their contraceptive method. Among the 23 women reached for a follow-up phone call six months later, all expressed high level of satisfaction with the service and indicated they would recommend it to other women in similar situations.
An integrated, specialized gynecological service that provides cervical testing and contraceptive counselling can effectively reach women receiving outpatient or inpatient treatment for SUD, who typically fail to follow-up routine women's health screening programmes. If implemented, this approach has the potential to reduce unplanned pregnancies and improve early detection of cervical pathology in this vulnerable population.
与一般女性人群相比，患有物质使用障碍（SUD）的女性面临更高的性侵犯、虐待、宫颈癌前病变和意外怀孕风险。为满足这一弱势群体的特殊需求，我们建立了一项全面的妇科服务。本研究旨在描述使用这些服务的患有SUD的女性的特征。此外，我们评估了她们的宫颈细胞学和性传播感染（STIs）检测结果、首选避孕方法以及该服务的总体可接受性。
我们纳入了挪威南特伦德拉格地区48名因SUD接受门诊或住院治疗的女性参与研究。每位女性都接受了全面的妇科问诊，包括性侵犯史，随后在妇产科门诊进行了妇科检查。检查包括薄层液基细胞学检测（ThinPrep Tests）和微生物拭子检测。还免费为她们提供了避孕选择，重点是长效可逆避孕方法（LARC）。参与者在咨询后立即以及六个月后对该服务提供了反馈。
平均年龄为31.8岁的女性中，近三分之二（63%）报告有性侵犯史。三分之一（33%）的女性宫颈细胞学或人乳头瘤病毒（HPV）检测结果需要治疗或随访，不过未发现性传播感染病例。三分之二（66%）符合条件的女性选择LARC作为她们的避孕方法。在六个月后通过电话随访联系到的23名女性中，所有人都对该服务表示高度满意，并表示会向其他处于类似情况的女性推荐。
一项提供宫颈检测和避孕咨询的综合、专门的妇科服务能够有效地惠及因SUD接受门诊或住院治疗的女性，这些女性通常未能遵循常规的女性健康筛查计划。如果实施这种方法，有可能减少该弱势群体中的意外怀孕，并改善宫颈病变的早期检测。
