Barriers to family planning services among patients in drug treatment programs
Armstrong, K.A.; Kenen, R.; Samost, L.
Family Planning Perspectives 23(6): 264-6 270-1
1991
ISSN/ISBN: 0014-7354 PMID: 1786807 DOI: 10.2307/2135777Document Number: 316610
Family planning (FP) services were integrated into 13 drug treatment programs in July 1989 in Philadelphia providing services to 1250 women a year on birth control methods, sexually transmitted diseases (STDs), HIV risk assessment, and pregnancy testing. Among 599 female drug treatment clients aged 16-56 baseline interviews were conducted followed up by interviews 9 months and 15 months later. 58% were black, 37% white, and 5% Asian. 58% had a high school education. 14% were married, and 36% were divorced, separated, or widowed. 81% already had 1 child. 25% had injected heroin and 16% cocaine in the previous 4 weeks. 76% of sexually active women had not used condoms. FP clients made 3139 visits in the course of 24 months for counseling and medical purposes. 6 focus groups with 30 men and 35 women aged 16-60 were conducted 12 months after the integration of services. Most were aware about the availability of FP services: 61% of 958 women received STD advice, 67% of 258 women at 4 sites were screened for gonorrhea and 40% for syphilis. 76% of 599 women stated that their last pregnancy had been unintended. Most thought that contraceptives caused weight gain, headache, water retention, mood swings, blood clots, bleeding, or cancer. Among the sample of 599 women 15% had used the condom, 55 had used the pill, 7% had used the sponge, the IUD, or others, 38% had not used any method in the preceding 4 weeks. 42% of 873 of sexually active women receiving FP counseling planned to use the condom. 27% of drug treatment clients had been sterilized. Most women did not use the condom or other contraceptives in order to preserve their relationships. Many had experienced violence, incest, sexual abuse, and rape. In an all-male focus group all had been either victims or committed sexual violence. Both staff and clients liked the integration of drug treatment and FP.