The Link between Substance Use and Reproductive Health Service Utilization among Young US Women

Abstract

Background

The authors sought to investigate associations between young women's use of alcohol and other substances and their sexual and reproductive health (SRH) service utilization.

Methods

The authors used data from 4421 young women aged 15–24 years in the nationally representative study, National Survey of Family Growth, 2002–2008. The authors examined associations between frequency of tobacco, alcohol, marijuana, and illicit drug use and SRH service use in the past year using logistic regression.

Results

Over half (59%) of the young women used SRH services, including contraception (48%), gynecological examination (47%), and sexually transmitted infection (STI) testing/treatment (17%) services. Proportions of SRH service use increased with higher frequencies of substance use (all P values <.001); service use was particularly common among daily substance users (range: 72% of daily marijuana users to 83% of daily binge drinkers). In multivariable analyses, associations between substance and SRH service use varied by substance and service type: weekly marijuana (odds ratio [OR] = 2.5, 95% confidence interval [95% CI] = 1.4, 4.3, P = .002) and alcohol (OR = 1.7, 95% CI = 1.1, 2.4, P = .01) use were positively associated with gynecological service use. All substances were positively associated with STI service use. However, daily smoking was negatively associated with contraceptive service use (OR = 0.6, 95% CI = 0.4, 0.8, P = .001).

Conclusion

SRH service use was common among women reporting frequent substance use. SRH settings provide an opportunity to deliver substance use screening and preventive care to young women.

Keywords

Alcohol health service utilization marijuana reproductive health substance use tobacco

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References

Santelli

J S

, Robin

, Brener

N D

and Lowry

. 2001. Timing of alcohol and other drug use and sexual risk behaviors among unmarried adolescents and young adults. Fam Plann Perspect., 33: 200–205.

US Department of Health and Human Services. 2011. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, Rockville, MD: Substance Abuse and Mental Health Services Administration. September

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Healthy Youth: Alcohol and drug use; Tobacco use. Available at: http://www.cdc.gov/healthyyouth. Accessed May 29, 2011

Centers for Disease Control and Prevention. 2010. Youth Risk Behavior Surveillance—United States, 2009. MMWR Morb Mort Wkly Rep., 59(SS-5): 1–142.

Substance Abuse and Mental Health Services Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings, 2012Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. NSDUH Series H-32, DHHS Publication No. SMA 07-4293

Naimi

T S

, Brewer

R D

, Mokdad

, Denny

, Serdula

M K

and Marks

J S

. 2003. Binge drinking among US adults. JAMA., 289: 70–75.

Hedlund

J H

, Ulmer

R G

and Preusser

D F

. 2001. Determine Why There Are Fewer Young Alcohol-Impaired Drivers, Washington, DC: US Department of Transportation. Report Number DOT HS 809 348

US Department of Transportation. Fatality Analysis Reporting System (FARS). Web-based Encyclopedia. Available at: http://www-fars.nhtsa.dot.gov/Main/index.aspx. Accessed November 8, 2012

Substance Abuse and Mental Health Services Administration. 1999. The Relationship Between Mental Health and Substance Abuse Among Adolescents, Rockville, MD: Substance Abuse and Mental Health Services Administration.

10.

Centers for Disease Control and Prevention. 2004. Alcohol-attributable deaths and years of potential life lost—United States, 2001. MMWR Morb Mort Wkly Rep., 53: 866–870.

11.

Walton

M A

, Resko

, Whiteside

, Chermack

S T

, Zimmerman

and Cunningham

R M

. 2011. Sexual risk behaviors among teens at an urban emergency department: relationship with violent behaviors and substance use. J Adolesc Health., 48: 303–305.

12.

Turner

A K

, Latkin

, Sonenstein

and Tandon

S D

. 2011. Psychiatric disorder symptoms, substance use, and sexual risk behavior among African-American out of school youth. Drug Alcohol Depend., 115: 67–73.

13.

Vijayakumar

, Kumar

M S

and Vijayakumar

. 2011. Substance use and suicide. Curr Opin Psychiatry., 24: 197–202.

14.

Calsyn

D A

, Baldwin

, Niu

, Crits-Christoph

and Hatch-Maillette

M A

. 2011. Sexual risk behavior and sex under the influence: an event analysis of men in substance abuse treatment who have sex with women. Am J Addict., 20: 250–256.

15.

Cavazos-Rehg

P A

, Krauss

M J

, Spitznagel

E L

, Schootman

, Cottler

L B

and Bierut

L J

. 2011. Number of sexual partners and associations with initiation and intensity of substance use. AIDS Behav., 15: 869–874.

16.

Herrick

A L

, Marshal

M P

, Smith

H A

, Sucato

and Stall

R D

. 2011. Sex while intoxicated: a meta-analysis comparing heterosexual and sexual minority youth. J Adolesc Health., 48: 306–309.

17.

Seth

, Sales

J M

, DiClemente

R J

, Wingood

G M

, Rose

and Patel

S N

. 2011. Longitudinal examination of alcohol use: a predictor of risky sexual behavior and Trichomonas vaginalis among African-American female adolescents. Sex Transm Dis., 38: 96–101.

18.

Alleyne

, Coleman-Cowger

V H

, Crown

, Gibbons

M A

and Vines

L N

. 2011. The effects of dating violence, substance use and risky sexual behavior among a diverse sample of Illinois youth. J Adolesc., 34: 11–18.

19.

Jones

H E

, Browne

F A

Myers

B J

. 2011. Pregnant and non-pregnant women in cape town, South Africa: drug use, sexual behavior, and the need for comprehensive services. Int J Pediatr., 2011: 353–410.

20.

Tapert

S F

, Aarons

G A

, Sedlar

G R

and Brown

S A

. 2001. Adolescent substance use and sexual risk-taking behavior. J Adolesc Health., 28: 181–189.

21.

Silverman

J G

, Raj

, Mucci

L A

and Hathaway

J E

. 2001. Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behavior, pregnancy, and suicidality. JAMA., 286: 572–579.

22.

Shahul

and Gfroerer

. 2003. Pregnancy-related substance use in the United States during 1996–1998. Obstet Gynecol., 101: 374–379. Ebrahim

23.

Kelly

R H

, Russo

Holt

. 2002. Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstet Gynecol., 100: 297–304.

24.

Reardon

D C

, Coleman

P K

and Cougle

J R

. 20. Substance use associated with unintended pregnancy outcomes in the national longitudinal survey of youth. Am J Drug Alcohol Abuse., 30(04): 369–383.

25.

Cornelius

M D

, Goldschmidt

, Day

N L

and Larkby

. 2002. Alcohol, tobacco and marijuana use among pregnant teenagers: 6-year follow-up of offspring growth effect. Neurotoxicol Teratol., 24: 703–771.

26.

Feng

. 1993. Substance abuse in pregnancy. Curr Opin Obstet Gynecol., 5: 16–23.

27.

Klein

J D

, McNulty

and Flatau

C N

. 1998. Adolescents’ access to care: teenagers’ self-reported use of services and perceived access to confidential care. Arch Pediatr Adolesc Med., 152: 676–682.

28.

Regier

D A

, Goldberg

I D

and Taube

C A

. 1978. The de facts vs. mental health services system. Arch Gen Psychiatry., 35: 685–693.

29.

US Department of Health and Human Services, Agency for Health Care Policy and Research. 1993. Depression in Primary Care: Treatment of Major Depression. Vol. 2, Rockville, MD: Agency for Health Care Policy and Research.

30.

Miranda

, Azocar

, Komaromy

and Golding

J M

. 1998. Unmet mental health needs of women in public-sector gynecologic clinics. Am J Obstet Gynecol., 178: 212–217.

31.

Crandall

L A

, Metsch

L R

, McCoy

C B

, Chitwood

D D

and Tobias

. 2003. Chronic drug use and reproductive health care among low-income women in Miami, Florida: a comparative study of access, need and utilization. J Behav Health Serv Res, 30: 321–331.

32.

Harwell

T S

, Spence

M R

, Sands

and Iguchi

M Y

. 1996. Substance use in an inner-city family planning population. J Reprod Med., 41: 704–710.

33.

Lepkowski

, Mosher

, Davis

, Groves

and Van Hoewyk

2010. The 2006–2010 National Survey of Family Growth: sample design and analysis of a continuous survey. National Center for Health Statistics. Vital Health Stat., 2: 1–36.

34.

Lepkowski

, Mosher

, Davis

, Groves

, van Hoewyk

and Willem

2006. National Survey of Family Growth, Cycle 6: sample design, weighting, imputation, and variance estimation. Vital Health Stat., 2: 1–82.

35.

Hall

, Moreau

and Trussell

. 2011. Discouraging trends in reproductive health service use among adolescent and young adult women in the United States: an analysis of data from the National Survey of Family Growth, 2002 to 2008. Hum Reprod., 26: 2541–2548.

36.

Potter

, Trussell

and Moreau

. 2009. Trends and determinants of reproductive health service use among young women in the USA. Hum Reprod., 24: 3010–3018.

37.

Aggarwal

S K

, Carter

G T

, Sullivan

M D

, Zum Brunnen

, Morrill

and Mayer

J D

. 2009. Medicinal use of cannabis in the United States: historical perspectives, current trends, and future directions. J Opioid Manag., 5: 153–168.

38.

White House Drug Policy. Epidemic: responding to America's prescription drug abuse crisis. 2011. Available at: http://www.whitehousedrugpolicy.gov/publications/pdf/rx_abuse_plan.pdf. Accessed June 27, 2011

39.

Shelton

J D

, Angle

M A

and Jacobstein

R A

. 1992. Medical barriers to access to family planning. Lancet., 340: 1334–1335.

40.

Egarter

, Strohmer

Lehner

. 1997. Contraceptive knowledge and attitudes of Austrian adolescents after mass media reports linking third-generation oral contraceptives with increased risk of venous thromboembolism. Contraception., 56: 147–152.

41.

Carbone

J C

, Kverndokk

and Røgeberg

O J

. 2005. Smoking, health, risk, and perception. J Health Econ., 24: 631–53.

42.

Substance Abuse and Mental Health Services Administration. Screening, brief intervention and referral to treatment (SBIRT). Available at: http://www.samhsa.gov/prevention/sbirt/. Accessed November 8, 2012