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

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.

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.

In our sample (N = 22), 59% identified as white 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.

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.