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Healthcare Access, Pregnancy Intention, and Contraceptive Practices Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee.

Authors
  • Leinaar, Edward1
  • Johnson, Leigh1
  • Yadav, Ruby1
  • Rahman, Abir1
  • Alamian, Arsham1
  • 1 From the Department of Health Services Management and Policy, College of Public Health, the Department of Family Medicine, Quillen College of Medicine, and the Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, Johnson City.
Type
Published Article
Journal
Southern Medical Journal
Publisher
Southern Medical Association
Publication Date
Jul 01, 2019
Volume
112
Issue
7
Pages
382–386
Identifiers
DOI: 10.14423/SMJ.0000000000000990
PMID: 31282967
Source
Medline
Language
English
License
Unknown

Abstract

Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and adequacy of access to reproductive healthcare among women receiving opioid agonist therapy in northeast Tennessee. A cross-sectional survey was piloted among female patients aged 18 to 55 years from two opioid agonist therapy clinics. Descriptive analyses were conducted using logistic regression to evaluate the statistical significance of bivariate associations. Of 91 participants, 84% reported having health insurance, with 70% perceiving having adequate access to health care. More than half had a history of unwanted pregnancy (53%), among whom few (23.1%) reported the consistent use of contraception at time of conception. Although most desired to avoid pregnancy (90%), only 59% of women reported the current use of regular contraception. Most of those not using regular contraception believed that they were not at risk for pregnancy (54.3%). Although most participants reported adequate access to health care and a desire to avoid pregnancy, few reported the consistent use of regular contraception. Furthermore, misperceptions regarding pregnancy risk were common among participants. Research is needed to identify barriers to contraceptive acceptance and causes of pregnancy risk misperceptions in this population of women at increased risk of unintended pregnancy.

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