Date of Publication
Amy O'Meara and Sarah Heil
Purpose: Women with opioid and other substance use disorders have a high rate of unintended pregnancy and a low rate of effective contraceptive use. Integrating family planning (FP) services into medication-assisted treatment (MAT) clinics has increased rates of initiation and adherence to contraception among this population. This study assesses the reproductive health needs of female clients in a syringe exchange program (SEP)to assess if integrating FP services would improve access to contraception.
Methods: Female clients of a SEP voluntarily completed an anonymous survey to determine demographics, FP needs, and barriers to accessing care, and were compensated with $20 gift cards. Descriptive statistics were used to analyze survey results. Interviews with SEP personnel and MAT researchers were thematically analyzed to determine key considerations relevant to implementing FP within the novel setting of a SEP.
Results: Women (N=42) averaged 32 years of age, had a high school education, and most were unemployed and on Medicaid. Preliminary results show familiarity with all contraception methods, with 50% reporting a history of using the most effective methods. About half (45%) reported their most recent pregnancy was unintended. Most (93%) were not currently seeking pregnancy, despite 50% not using any contraception or using less effective methods. Thirteen potential barriers to accessing contraception were endorsed, led by concerns about cost, transportation, provider coercion, and provider stigma. The majority of women (70%) were interested in receiving FP services at the SEP. Qualitative interviews with SEP staff and MAT researchers strongly supported integration of FP services with adaptation to the unique SEP setting.
Conclusions: There is client and staff interest in integrating FP services within the SEP setting, with the majority of clients at risk of unplanned pregnancy. Successful implementation of this care would overcome barriers to accessing FP services, and will require a model specifically tailored to the SEP setting.
Keywords: Opiate use disorder, contraception, harm reduction, syringe-exchange
Zollman, Gena, "Improving Contraception among Female Syringe Exchange Clients: A Reproductive Needs Assessment" (2019). College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications. 25.