Sexual health risks and health-seeking behaviours among substance-misusing women
Article first published online: 7 MAY 2014
© 2014 John Wiley & Sons Ltd
Journal of Advanced Nursing
How to Cite
2014) Sexual health risks and health-seeking behaviours among substance-misusing women. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/jan.12442, , & (
- Article first published online: 7 MAY 2014
- Manuscript Accepted: 5 APR 2014
- Research for Patient Benefit Programme. Grant Number: PB-PG-0407-13149
- injecting drug use;
- sexual health;
- substance misuse;
To report on a survey of sexual health service needs among substance-misusing women attending a substance misuse service.
Substance-misusing women carry a disproportionate burden of sexual ill health, yet the range and frequency of their sexual health risks, morbidities and service engagement are poorly understood.
A cross-sectional survey of a convenience sample of substance-misusing women attending a substance misuse service.
From 4 April 2010–17 September 2010, substance-misusing women in Hastings & Ore, UK, were invited to complete a paper questionnaire addressing: drug use; cervical cytology, sexually transmitted infection and HIV screening history; pregnancy history, perceived pregnancy risk and contraceptive advice and supply; sexual activity and assault. Of 91 respondents, 77 attended local drug treatment services – results comprise analysis of this sub-sample.
The study sample was characterized by long-term opioid and crack cocaine use. Of 53% sexually active in the previous 4 weeks, 66% perceived they had experienced sexual intercourse that could lead to pregnancy during that time. Fifty-five per cent had been forced to have sex against their will during their lifetime. High rates of sexually transmitted infections, pregnancy termination, miscarriage and abnormal cervical cytology were reported.
Findings indicate the need to recognize the breadth of elevated sexual health risks and morbidities experienced by substance-misusing women with long-term opioid/crack use, including those not identifying as intravenous drug users. Poor recall of drop-in and appointment times, reluctance to disclose substance misuse and likelihood of previous sexual assault present significant challenges to nurses, who must take a sensitive, opportunistic approach to referral and provision of sexual health interventions to substance-misusing women.