Experiences and Perspectives of Sexual and Reproductive Health Among Women in Recovery From Opioid Use Disorder.

Background: Women in recovery from opioid use disorder (OUD) have unmet sexual and reproductive health (SRH) needs resulting in health disparities such as unintended pregnancy and sexually transmitted infections/HIV infection compared with women without OUD. The purpose of this qualitative descriptive study was to explore the perceptions and experiences of co-occurring multiple social-ecologic influences (individual, interpersonal, community, society) on SRH among women in recovery from OUD.

Methods: Purposive sampling was used to recruit cis-gender women aged 18-49 who self-identify as being in recovery from OUD and speak English. We conducted one 45- to 60-minute audio-recorded semistructured telephone interview with each participant.

Results: In our sample (N = 22), 59% identified as white/Caucasian and the mean age was 34.7 years (SD = 6.8). We identified themes related to SRH across social-ecological levels. Holistic Definition of SRH: Participants described an evolution of their knowledge and behaviors related to SRH during recovery to include preventive health, emotional well-being, and healthy relationships. Reevaluation of Relationships: Participants described undergoing a critical appraisal of their relationships and identified relationships that strengthened or threatened their recovery. Built and Lived Community: Participants described a rebuilding and restructuring of both social and physical domains of community. Shadow of Stigma: Participants described experiencing stigmatizing behaviors related to the interconnectedness of their childbearing capacity, SRH, and recovery.

Conclusions: Women's expansive descriptions of SRH in recovery extend beyond access to contraception and sexually transmitted infection/HIV screening. Interventions focused on SRH must account for the complex multilevel influences on the health of women in recovery from OUD.