Internal or Infernal Devices: Experiences of Contraception Among Australian Women Living With Hepatitis C

Abstract

In this article we seek to delineate the experiences of contraceptive use by Australian women living with hepatitis C. Using semi-structured, in-depth interviews, 109 women with hepatitis C from two cities in Australia, Melbourne (Victoria) and Canberra (the Australian Capital Territory), were interviewed about their alcohol and other drug use, their contraceptive history, and their experiences of hepatitis C. We aimed to understand why such a high proportion of women living with hepatitis C (66%) had previously reported that they were not currently using contraception. Many women had used contraception at some stage of their lives but were no longer using it because they had experienced contraceptive failure or uncomfortable side effects. Others were concerned about the impact of contraception on their fertility, were planning to get pregnant or considered themselves to be celibate. Hepatitis C appeared to have little impact on their contraceptive practices, but some women's illicit drug use had an important influence. Illicit drug use was, for some, an encouragement to seek long-term forms of contraception that reduced their chances of pregnancy while for others drug taking hampered their contraceptive use. In compliance with health promotion campaigns of the last two decades, women were generally more concerned about preventing sexually transmissible infections than pregnancies, particularly with new or casual partners.

Living with Hepatitis C Virus: A Systematic Review and Narrative Synthesis of Qualitative Literature

“…Some of the included studies assessed the same group of people but reported on different aspects of living with HCV: Olsen et al [21], Olsen et al [22], and Olsen et al [23]; Harris [24] and Harris [25]; and Tompkins et al [60] and Wright et al [61]. Thirty-eight studies included participants from a general population [21, 23–59], seven included participants who were IDUs [22, 60–65], and one included participants who received contaminated blood products [66]. The broad themes identified did not differ across these populations, so the findings are described together.…”

“…Seventeen studies were conducted in Australia [21–23, 25, 30, 32, 33, 38, 39, 51, 53, 56–59, 64, 65], fifteen in the UK [24, 31, 34, 35, 37, 40, 46, 47, 49, 52, 55, 60, 61, 63, 66], eight in the United States [26, 27, 36, 41, 43, 48, 54, 62], four in Canada [28, 29, 45, 50], and one each from Pakistan [42] and France [44]. The studies were published between 1999 [39] and 2014 [40, 48].…”

“…The studies were published between 1999 [39] and 2014 [40, 48]. Data in these studies were analyzed using a variety of methods, including thematic and content analysis [21–23, 27, 45, 48, 56, 60, 64], inductive approach [28, 54, 57, 59], grounded theory [30, 32, 35, 46, 63], framework approach [61], phenomenological approach [31, 37, 40, 43, 51, 52, 66], interpretive approach [33, 39], and constant comparative analysis [41, 50]. Various software programs were used by these studies: NVivo [28, 29, 47, 48, 55, 62], atlas.ti [21–23, 26], and QSR ∗ NUDIST [41].…”

Fertility-related research needs among women at the margins

“…[134][135][136] Low contraceptive use and high unmet need for family planning has been documented in several studies. 63,[137][138][139] Further investigation is needed, particularly into how sexual and reproductive health services and parenting skills-building can be integrated into substance use treatment programmes and other health interventions serving people who use drugs. [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.…”

Australians Living with and Managing Hepatitis C

“…In particular, we focus on the issues surrounding the person's mental health in respect to a recent chronic illness diagnosis, discuss how to manage the trajectory of the illness in the community, and identify how disclosure of HCV affects intimacy (Olsen, Banwell, & Dance, 2009).…”