Female sexual health problems in a drug dependency unit.

The Government of the United Kingdom has produced a strategic plan called the Health of the Nation aimed at achieving better health in key areas including a reduction in rates of unwanted pregnancies, sexually transmitted diseases and cervical cancer. Conventional health care systems fail some groups with special needs. This cross-sectional interview study was undertaken to determine the level and type of contraceptive use, and the attitudes of female opiate abusers to the use and availability of contraceptives and cytology services. The subjects were 201 opiate-dependent women enrolled in a methadone maintenance programme in a large drug dependency unit: 169 (84.5%) were sexually active and 65 (44.2%) of non-pregnant sexually active women did not use a contraceptive method. Thirty-six (43.9%) of those using a contraceptive were using condoms, with which the majority were dissatisfied. Sixty-one (30.3%) had never had a cervical cytology smear and of those who had, 21.4% reported an abnormal result. The contraceptive practices and uptake of cervical screening services by the women studied are inadequate, reflecting poor use of conventional health care services. In addition to providing information on safer sexual practices, particularly promotion of condom use, we suggest that drug dependency units should expand their role to provide educational and preventative services to include aspects of women's health.