A Comparison of Sex-Specific Reproductive and Sexual Health Needs between Addiction Medicine and Primary Care Treatment Settings

Abstract

Introduction: Reproductive and sexual health (RSH) is an important component of wellness and recovery for people with substance use disorder (SUD). Evidence to guide better integration of RSH services into SUD treatment is limited. Our objectives were to compare 1) unmet RSH needs; and 2) barriers to RSH service utilization between care settings providing treatment for SUD or other chronic medical conditions. Methods: Participants at two outpatient clinics, addiction medicine (women n = 91, men n = 75) and primary care (women n = 59, men n = 50), completed a one-time electronic survey between July and September 2019. Separately for men and women, comparisons between addiction medicine and primary care groups were made using Pearson χ², Fisher’s Exact, and T-tests. Results: Participants were 75.0% Black and aged 49.4 years. Overall, unmet RSH needs were less prevalent among participants at the primary care than the addiction medicine clinic, such as receipt of a past 12-month sexual exam (men: 36.0% vs. 17.3%; women: 55.6% vs. 30.1%). The most common barrier to RSH service receipt was cost (men: 59.4%; women: 52.6%), followed by fear of judgment for drug/alcohol use for SUD participants (men: 33% vs. 12%; women: 26% vs. 7%). Many SUD participants expressed high desire for integrated RSH services into the addiction medicine clinic (men: 51.4%; women: 59.8%). Conclusion/Implications: The integration of RSH into addiction medicine is lagging compared to care settings for people with other chronic medical conditions. Future research should focus on advancing sex- and gender-informed RSH service integration into SUD treatment settings.

Keywords:

• Substance use disorder
• reproductive health
• sexual health
• gender
• sex

Acknowledgments

The authors would like to thank Dr. Lauren MacAfee for her assistance with study survey design.

Declaration of interest

The authors have no conflicts of interest to disclose.

Additional information

Funding

This project was supported by the Jeanann Gray Dunlap foundation as well as partially by CTSA award Nos. UL1TR002649 and KL2TR002648 from the National Center for Advancing Translational Sciences. Dr. Martin is supported by NIDA K23DA053507. Anna Beth Parlier-Ahmad is supported by NIDA T32DA007027. Vashali Jain was supported by funding from the School of Medicine at Virginia Commonwealth University through the Dean’s Summer Research Fellowship Program.