UCSF

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.