Young women's use of substances and reproductive health services: Is there a link?

Objective: To investigate associations between young women's use of substances and preventive sexual and reproductive health (SRH) services.

Methods: We used data from young women 15-24yrs (n=4,421) in the National Survey of Family Growth, 2002-2008. With descriptive, bivariate and multivariate logistic regression statistics, we analyzed relationships between recent use of tobacco, alcohol, marijuana and illicit drugs and use of preventive SRH services.

Results: Over half (59%) young women used SRH services including contraception (48%), gynecological exam (47%), and STI testing/treatment (17%) services. Proportions of service use increased with frequency of all substance use (p-values<0.001). Among sexually-experienced women, weekly marijuana use was positively associated with SRH service use (OR 2.7,CI 1.3,5.3,p=0.006), including gynecological exam services (OR 2.5,CI 1.4,4.3,p=0.002). Alcohol use was also associated with gynecological services. Daily smoking was negatively associated with service use (OR 0.6,CI 0.4,0.9,p=0.02), including contraceptive services (OR 0.6,CI 0.4,0.8,p=0.001). All substances were positively associated with STI service use.

Conclusion: Associations between substance use and SRH service use varied by substance and service type. Future research can determine socioeconomic differentials, implications for substance use screening in SRH settings and strategies to improve preventive care-seeking among tobacco-users.