1. Females with opioid use disorder have many logistical barriers to accessing contraceptives, including homelessness and lack of transportation.
2. This study found accessing contraceptives at syringe exchange programs may be one avenue to provide contraceptive care in this population.
Evidence Rating Level: 3 (Average)
Compared to the general United States population, women who have opioid use disorder (OUD) are far more likely to have unintended pregnancies. Almost 90% of pregnancies of women with OUD are unintended. Prior research has suggested that these individuals are much less likely to use contraceptive methods, such as condoms. However, prior research has not explored the reasons for such disparities in contraceptive methods.
This study used a sample recruited from a volunteer-run non-profit syringe exchange program (SEP) in Santa Ana, California, United States of America between March and December 2019. Participants were included if they were aged 18-45, used injection drugs, spoke English or Spanish, and did not intend to become pregnant (n=14). Interviews were conducted with the participants. This qualitative study assessed outcomes related to patient experiences with contraception, past experiences with health care providers, and ability to obtain contraceptives.
From the interviews, most participants noted that contraception was not a main priority during periods of substance abuse. Participants also noted logistical barriers, including homelessness, lack of transportation, and lack of insurance as a financial barrier to contraception. Several participants additionally believed they could not become pregnant while using substances due to the lack of menstrual periods. Participants did note that they would probably use contraceptives if they were more readily accessible and incorporated as another service at syringe exchange programs. This study did have several limitations, notably its small sample size, homelessness as a potential confounding variable, and social desirability bias. Despite these limitations, this study furthered our understanding of barriers to contraceptive use in this population.
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