INTRODUCTION

The dual epidemics of sexually transmitted infections (STIs) and unprescribed opioid use persist globally, including in the United States. This study addresses gaps in STI prevention and contraception among people who use unprescribed opioids in New York City (NYC), focusing on both men and women.

METHODS

We conducted a cross-sectional substudy from November 2021-August 2022 assessing sexual health with a one-time survey within a longitudinal cohort study among people who use unprescribed opioids in NYC that collected baseline data during 2019-2020. We measured sociodemographic characteristics, substance use history, sexual partnerships and STI prevention and contraception categorized as providing effective prevention versus none/ineffective. We estimated the prevalence of lack of effective STI prevention and contraception and potential correlates among males and females.

RESULTS

The analytic sample included 108 participants (54 % male, 46 % female) with a mean age of 46 years. No/ineffective STI prevention was most common among reproductive-age females (81 %) and lowest among males (67 %) and no/less effective contraception was reported by approximately 90 % of participants. No/ineffective STI prevention and contraception were differentially associated with factors such as sexual partnerships, substance use treatment, and healthcare utilization among males and females.

DISCUSSION

Findings highlight the need for improved provision of effective STI and pregnancy prevention methods for both men and women who use drugs. There is a critical need to expand access to sexual and reproductive health services for people who use drugs, including integrating these services into diverse healthcare and drug-service settings.