Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia: Table 1

Abstract

Background This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. Methodology A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Results Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11–2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36–0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33–0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49–0.97, p = 0.03). Conclusions Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

Abortion and sex-related conditions in substance-dependent Brazilian patients

“…This is one of few clinical Brazilian studies undertaken in a clinical setting to evaluate abortion prevalence in a large drug user sample. Abortion is a method used to prevent births in many developing countries 21 including in Brazil 6,35 and rates remain high around the world 13,36,37,38 . The association between abortion and substance use is a public health problem of great magnitude which makes a substantial contribution to maternal morbidity and mortality 1,2,3,39 .…”

“…The SADD is a scale consisted of 15 questions related to the alcohol dependence severity, classified on a scale from 0 to 20, and scored as follows: mild (0-9), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and severe (≥ 20). The Brazilian version and the original English version of the SADD are highly correlated and the coefficient of internal consistency is 0.79 33 .…”

“…Even when there is a severe foetal malformation as in anencephaly, abortion is only permitted after judicial authorization 9,11 . Still, little progress in this field has been observed from the public health perspective in Brazil, as the complications of abortion are among the major causes of maternal mortality 9,12 , which seems to be repeatedly true for the most vulnerable population, such as the chronic drug users 13,14,15,16,17,18 .…”

“…Saúde Pública 2017; 33(11):e00143416 and discrimination, fading the ability to provide appropriate health care interventions 29 . A study conducted with 80 sexually active IDU women in Saint Petersburg, Russia, showed that 67% had undergone abortion and consistent condom use was reported by only 22% of the subjects 13 .…”

Fertility-related research needs among women at the margins

“…[140][141][142] High rates of abortion have been reported among women who use drugs, some of whom are also sex workers, however, reduction in abortion-related risks and integration of family planning and post-abortion care in this population has not adequately been documented. [143][144][145] Fertility-related assessments prior to pregnancy in this population are limited, although studies focused on women living with HIV in Canada, including women who use drugs, suggested that drug use did not affect fertility intentions. 146 Evidence-based and human rightsaffirming interventions are needed at this time when certain programming efforts incentivize contraceptive use or sterilization among women who use drugs.…”