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Objectives
Limited data exist surrounding family planning decision making of people who inject
drugs (PWID). This study explored the contraceptive practices and needs of PWID for
the purpose of implementing values-based contraceptive resources at a syringe exchange
program (SEP).
Methods
Using a mixed-methods design, we collected 68 quantitative surveys and 16 qualitative,
semi-structured interviews with female-identifying, English-speaking clients of a SEP
in Rochester, New York. Quantitative data was analyzed with descriptive statistics
and qualitative data was coded and analyzed using grounded theory until thematic saturation
was reached.
Results
63.2% of survey respondents did not desire pregnancy in the next year, and 52.2% have
experienced unintended pregnancy in the past. Of the 51.5% of respondents not using
contraception, 54.3% were interested in initiating it. When deciding contraceptive
methods, participants valued ease of access (37.5%), effectiveness (34.4%), and limited
required follow up (21.9%). Qualitative interviewees described their “ideal pregnancy”
as including increased financial and relationship stability, a decrease in drug use,
and the ability to provide their children with opportunities to thrive. Provider stigma
often prevented PWID from obtaining contraception through traditional healthcare settings,
but SEPs were trusted resources in the community. Both survey and qualitative participants
felt contraceptive services through an SEP would be convenient and comfortable, with
54.6% of total survey respondents interested in these services.
Conclusions
PWID identify key values in contraceptive choices and future pregnancies and view
SEPs as trusted service providers. Although decision-making is complex and individualized,
understanding the experiences of PWID is an important step in making family planning
services equitable.
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Copyright
© 2022 Published by Elsevier Inc.
