title: The link between substance use and reproductive health service utilization among young U.S. 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, and Institute for Social Research, University of Michigan, Ann Arbor, MI 48109, USA. hkelli@umich.edu
authors.forename: Kelli
authors.initials: K
authors.lastname: Stidham Hall
authors.forename: Caroline
authors.initials: C
authors.lastname: Moreau
authors.forename: James
authors.initials: J
authors.lastname: Trussell
mesh_terms: D000293:Adolescent; D005260:Female; D006306:Health Surveys; D006801:Humans; D034121:Reproductive Health Services / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult