Understanding barriers to sexual health service access among substance-misusing women on the South East coast of England.
OBJECTIVE
Evidence suggests substance-misusing women (SMW) experience disproportionate sexual health morbidity and poor uptake of interventions including contraception and cervical screening, yet there has been little investigation of sexual health service access issues for this population.


METHODS
Twenty women with problem drug use in Hastings in South East England, UK participated in a one-to-one interview with a researcher to explore experiences and beliefs surrounding access to a range of sexual health service interventions. Transcripts were open-coded and themes were elicited and organised concerning barriers to access.


RESULTS
Drug-use lifestyles, trauma and low self-worth framed the lives of SMW and hindered sexual health service access through: depleted practical and emotional resources to enable attendance; high perceived emotional cost of discussing sexual histories, and coping with tests and unfavourable results; and low anticipated value of sexual health interventions due to low perception and minimisation of risk and perceived incompatibility between drug use and sexual well-being.


CONCLUSIONS
A range of practical, social and emotional barriers to sexual health service access exist for this population, presenting a context from within which use of services may come at considerable personal cost to SMW. Interventions addressing anticipated stigma and emotional, hygiene and fiscal concerns are warranted for this population.
Senior Research Fellow, Centre for Health Research, University of Brighton, Falmer, UK.
Natalie Lois
NL
Edelman
Harish
H
Patel
Anthony
A
Glasper
Leanne
L
Bogen-Johnston
D055030:Drug Users; D004739:England; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D034121:Reproductive Health Services; D012649:Self Concept
cervical screening; contraception; genitourinary medicine; service delivery; sexually transmitted infections