Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee

Edward Leinaar; Billy Brooks; Leigh Johnson; Arsham Alamian

Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee

Edward Leinaar
, Billy Brooks
, Leigh Johnson
, Arsham Alamian

East Tennessee State University

Research output: Contribution to conference › Presentation

Abstract

background Women with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD.

objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT).

methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies.

results Of 91 participants, most were insured (84.4%), experienced at least one barrier (75.8%), and more than half reported unwanted pregnancies (52.8%). Most desired to avoid pregnancy (60.0%) or were ambivalent (30.0%). Common barriers were side effect aversion (53.8%), provider stigmatization (30.7%), appointment compliance (30.23%), and cost (25.0%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies.

conclusion While most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.

Original language	American English
State	Published - Nov 6 2019
Event	American Public Health Association, 2019 Annual Meeting and Exposition - Philadelphia, PA Duration: Nov 6 2019 → …

Conference

Conference	American Public Health Association, 2019 Annual Meeting and Exposition
Period	11/6/19 → …

Keywords

barriers
contraceptive access
reproduction
women

Cite this

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title = "Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee",

abstract = " background Women with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD. objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT). methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies. results Of 91 participants, most were insured (84.4\%), experienced at least one barrier (75.8\%), and more than half reported unwanted pregnancies (52.8\%). Most desired to avoid pregnancy (60.0\%) or were ambivalent (30.0\%). Common barriers were side effect aversion (53.8\%), provider stigmatization (30.7\%), appointment compliance (30.23\%), and cost (25.0\%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies. conclusion While most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.",

keywords = "barriers, contraceptive access, reproduction, women",

author = "Edward Leinaar and Billy Brooks and Leigh Johnson and Arsham Alamian",

year = "2019",

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day = "6",

language = "American English",

note = "American Public Health Association, 2019 Annual Meeting and Exposition ; Conference date: 06-11-2019",

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TY - CONF

T1 - Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee

AU - Leinaar, Edward

AU - Brooks, Billy

AU - Johnson, Leigh

AU - Alamian, Arsham

PY - 2019/11/6

Y1 - 2019/11/6

N2 - background Women with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD. objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT). methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies. results Of 91 participants, most were insured (84.4%), experienced at least one barrier (75.8%), and more than half reported unwanted pregnancies (52.8%). Most desired to avoid pregnancy (60.0%) or were ambivalent (30.0%). Common barriers were side effect aversion (53.8%), provider stigmatization (30.7%), appointment compliance (30.23%), and cost (25.0%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies. conclusion While most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.

AB - background Women with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD. objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT). methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies. results Of 91 participants, most were insured (84.4%), experienced at least one barrier (75.8%), and more than half reported unwanted pregnancies (52.8%). Most desired to avoid pregnancy (60.0%) or were ambivalent (30.0%). Common barriers were side effect aversion (53.8%), provider stigmatization (30.7%), appointment compliance (30.23%), and cost (25.0%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies. conclusion While most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.

KW - barriers

KW - contraceptive access

KW - reproduction

KW - women

UR - https://dc.etsu.edu/etsu-works/8182

M3 - Presentation

T2 - American Public Health Association, 2019 Annual Meeting and Exposition

Y2 - 6 November 2019

ER -

Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee

Abstract

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