Bridging the Gaps in Women's Primary Care for Those Treated at a Residential Drug Treatment Facility in Southwest Ohio

Abstract

Background: Patients with substance use disorders (SUD) have higher rates of sexually transmitted infections (STI) and limited utility of preventive and outpatient primary care. Women with SUD are a particularly vulnerable population requiring consistent primary and reproductive health care. This study evaluated the need for providing women’s primary health care to patients in a residential SUD treatment facility in rural southwest Ohio.
Methods: A retrospective chart review was conducted using intakes at a female-only residential SUD treatment facility from 2021-2022. Variables recorded in this study were: 1) patient-reported substance use; 2) laboratory screenings for hepatitis B, hepatitis C, HIV, and STIs; 3) reproductive history (contraceptive, Papanicolaou (Pap) test, and pregnancy history); 4) patient-reported connection with a primary care provider (PCP); and 5) patient-reported mental health disorders. The analysis provided descriptive statistics to identify comorbidities and trends in women with SUD.
Results: All completed intake charts were reviewed (n=159) without exclusions. No current PCP was reported in 59% of patients. Papanicolaou tests were needed in 50% of patients, and, of those completed, six (21%) had abnormal results. Almost 20% of patients were found with a positive STI, with highest prevalence of trichomoniasis (23%). Viral infection rate was 42%, the most common being hepatitis C (35% with active infection). Patient-reported comorbid psychiatric illness was 90%, the most common being generalized anxiety disorder (GAD) at 67.3%.
Conclusion: This study supports the need for whole person primary care in residential SUD treatment facilities, particularly in respect to viral and sexually transmitted infections, and for overall women's health.