Injectable Contraceptive Continuation among Female Exotic Dancers Seeking Mobile Reproductive Health Services

Martin, Caitlin E.; Han, Jenny E.; Serio-Chapman, Chris; Chaulk, Patrick; Terplan, Mishka

doi:10.1353/hpu.2014.0134

Cited by 8 publications

(8 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 43 Clinicians need to consider what constitutes patient-centered contraceptive counseling and family planning, 44 particularly given the stigma, discrimination, and historical harms WWUD have experienced and concerns around possible or perceived coercion. There is a critical need for development of women-specific integrated programs offering SUD treatment and/or harm reduction services with reproductive health services, 30 , 45 , 46 in various service delivery models. Pregnant and parenting WWUD may also benefit from these types of care models.…”

Section: Discussionmentioning

confidence: 99%

Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey

Levander

Foot

Magnusson³

et al. 2022

J GEN INTERN MED

View full text Add to dashboard Cite

Background Women who use drugs (WWUD) have low rates of contraceptive use and high rates of unintended pregnancy. Drug use is common among women in rural U.S. communities, with limited data on how they utilize reproductive, substance use disorder (SUD), and healthcare services. Objective We determined contraceptive use prevalence among WWUD in rural communities then compared estimates to women from similar rural areas. We investigated characteristics of those using contraceptives, and associations between contraceptive use and SUD treatment, healthcare utilization, and substance use. Design Rural Opioids Initiative (ROI) — cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions (January 2018–March 2020); National Survey on Family Growth (NSFG) — nationally-representative U.S. household reproductive health survey (2017–2019). Participants Women aged 18–49 with prior 30-day non-prescribed opioid and/or non-opioid injection drug use; fecundity determined by self-reported survey responses. Main Measures Unweighted and RDS-weighted prevalence estimates of medical/procedural contraceptive use; chi-squared tests and multi-level linear regressions to test associations. Key Results Of 855 women in the ROI, 36.8% (95% CI 33.7–40.1, unweighted) and 38.6% (95% CI 30.7–47.2, weighted) reported contraceptive use, compared to 66% of rural women in the NSFG sample. Among the ROI women, 27% had received prior 30-day SUD treatment via outpatient counseling or inpatient program and these women had increased odds of contraceptive use (aOR 1.50 [95% CI 1.08–2.06]). There was a positive association between contraception use and recent medications for opioid use disorder (aOR 1.34 [95% CI 0.95–1.88]) and prior 6-month primary care utilization (aOR 1.32 [95% CI 0.96–1.82]) that did not meet the threshold for statistical significance. Conclusion WWUD in rural areas reported low contraceptive use; those who recently received SUD treatment had greater odds of contraceptive use. Improvements are needed in expanding reproductive and preventive health within SUD treatment and primary care services in rural communities.

show abstract

Section: Discussionmentioning

confidence: 99%

Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey

Levander

Foot

Magnusson³

et al. 2022

J GEN INTERN MED

View full text Add to dashboard Cite

show abstract

“…28 Finally, while MMUs have shown high reach and uptake for contraception in low and middle-income countries, their use to among at-risk populations in the U.S. has not been extensively evaluated, and few have included LARC. [29][30][31][32] Our study is the rst to estimate the impact of MMU-based contraception care compared to EUC.…”

Section: Discussionmentioning

confidence: 99%

Contraception use among individuals with substance use disorder increases 10-fold with patient-centered, mobile services: a quasi- experimental study

Hurley

Goggin

Piña-Brugman

et al. 2022

Preprint

View full text Add to dashboard Cite

Background Individuals with substance use disorders (SUD) have disproportionately high rates of unintended pregnancy. Reducing harm associated with this risk and its biopsychosocial consequences requires evidence-based, non-coercive interventions that ensure access to contraception for individuals who choose to prevent pregnancy. We aimed to examine feasibility and impact of SexHealth Mobile, a mobile unit-based intervention aiming to increase access to patient-centered contraceptive care for individuals in SUD recovery programs. Methods We conducted a quasi-experimental study (enhanced usual care [EUC] followed by intervention) at three recovery centers with participants (n = 98) at risk for unintended pregnancy. EUC participants were offered printed information on community locations where they could access contraception care. SexHealth Mobile participants were offered same-day, onsite clinical consultation on a medical mobile unit and contraception if desired. The primary outcome was use of hormonal contraception/IUD at one-month post-enrollment. Secondary outcomes were use at two-weeks and three-months. Confidence in preventing unintended pregnancy, reasons for non-use of contraception at follow-up, and intervention feasibility were also assessed. Results Participants (median age = 31, range 19–40) enrolled in the intervention were almost 10 times more likely to be using contraception at one-month (51.5%) versus the those enrolled in the EUC period (5.4%) (unadjusted relative risk [URR] = 9.3 [95%CI: 2.3–37.1]; adjusted relative risk [ARR] = 9.8 [95%CI: 2.4–39.2]). Intervention participants were also more likely to be using contraception at 2-weeks (38.7% vs. 2.6%; URR = 14.3 [95%CI: 2.0-104.1]) and three-months (40.9% vs. 13.9%; URR = 2.9 [95% CI: 1.1–7.4]). EUC participants reported more barriers (cost, time) and less confidence in preventing unintended pregnancies. Mixed-methods feasibility data indicated high acceptability and feasible integration into recovery settings. Conclusions Mobile contraceptive care based on principles of reproductive justice and harm reduction reduces access barriers, is feasible to implement in SUD recovery settings, and increases contraception use. Following the overturning of Roe v. Wade, expanding interventions like SexHealth Mobile may help reduce harm from unintended pregnancies among individuals in SUD recovery. Trial Registration: NCT04227145

show abstract

“…After 12 months, only 7% of those who initiated injectable contraception were still returning for their three-month dose. 29 A more recent Hawaiian program piloted contraception injections at an SEP but reported only one client who initiated injections. Authors attributed this low uptake to lack of privacy for contraceptive discussions and insufficient integration of trusted staff with the new services, highlighting the critical role of patientcentered service design.…”

Section: Discussionmentioning

confidence: 99%

Expanding Contraception Access for Women With Opioid-Use Disorder: A Qualitative Study of Opportunities and Challenges

et al. 2020

View full text Add to dashboard Cite

Purpose: As almost nine in ten pregnancies among women with opioid use disorder (OUD) are unintended, expanding access to contraception is an underutilized but potentially effective strategy in increasing reproductive agency and reducing the overall burden of neonatal abstinence syndrome. We aimed to identify where and how contraceptive services could be integrated into existing points-of-contact for women with OUD. Approach: In-depth qualitative interviews. Setting: Three diverse catchment areas in Missouri. Participants: Women with OUD (n = 15) and professional stakeholders (n = 16) representing five types of existing OUD service points: syringe exchange programs, recovery support programs, substance use treatment programs, emergency departments, and Federally Qualified Health Centers. Method: Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software. Results: Six themes emerged as essential components for integrating contraceptive services into existing points-of-contact for women with OUD: (1) reach women with unmet need; (2) provide free or affordable contraception; (3) maximize service accessibility; (4) provide patient-centered care; (5) employ willing, qualified contraceptive providers; and (6) utilize peer educators. Participants affirmed the overall potential benefit of contraceptive service integration and illuminated various opportunities and challenges relevant to each type of existing service point. Conclusion: As health promotion initiatives look to increase access to contraception among women with OUD, these six’ participant-identified components offer essential guidance in selecting advantageous points-of-contact and addressing remaining gaps in services.

show abstract

Injectable Contraceptive Continuation among Female Exotic Dancers Seeking Mobile Reproductive Health Services

Abstract: A subset of female exotic dancers may favor DMPA as a long term contraceptive. Integrating mobile reproductive health services into public health programs can help fulfill the unique health needs of this high-risk population.

Cited by 8 publications

References 35 publications

Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey

Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey

Contraception use among individuals with substance use disorder increases 10-fold with patient-centered, mobile services: a quasi- experimental study

Expanding Contraception Access for Women With Opioid-Use Disorder: A Qualitative Study of Opportunities and Challenges

Contact Info

Product

Resources

About