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Drug use is common among women in rural U.S. communities, with limited data on how they utilize reproductive, substance use disorder (SUD), and healthcare services.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>We determined contraceptive use prevalence among WWUD in rural communities then compared estimates to women from similar rural areas. We investigated characteristics of those using contraceptives, and associations between contraceptive use and SUD treatment, healthcare utilization, and substance use.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Design<\/jats:title>\n                <jats:p>Rural Opioids Initiative (ROI) \u2014 cross-sectional survey using respondent-driven sampling (RDS) involving eight rural U.S. regions (January 2018\u2013March 2020); National Survey on Family Growth (NSFG) \u2014 nationally-representative U.S. household reproductive health survey (2017\u20132019).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Participants<\/jats:title>\n                <jats:p>Women aged 18\u201349 with prior 30-day non-prescribed opioid and\/or non-opioid injection drug use; fecundity determined by self-reported survey responses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Main Measures<\/jats:title>\n                <jats:p>Unweighted and RDS-weighted prevalence estimates of medical\/procedural contraceptive use; chi-squared tests and multi-level linear regressions to test associations.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Results<\/jats:title>\n                <jats:p>Of 855 women in the ROI, 36.8% (95% CI 33.7\u201340.1, unweighted) and 38.6% (95% CI 30.7\u201347.2, weighted) reported contraceptive use, compared to 66% of rural women in the NSFG sample. Among the ROI women, 27% had received prior 30-day SUD treatment via outpatient counseling or inpatient program and these women had increased odds of contraceptive use (aOR 1.50 [95% CI 1.08\u20132.06]). There was a positive association between contraception use and recent medications for opioid use disorder (aOR 1.34 [95% CI 0.95\u20131.88]) and prior 6-month primary care utilization (aOR 1.32 [95% CI 0.96\u20131.82]) that did not meet the threshold for statistical significance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>WWUD in rural areas reported low contraceptive use; those who recently received SUD treatment had greater odds of contraceptive use. Improvements are needed in expanding reproductive and preventive health within SUD treatment and primary care services in rural communities.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11606-022-07558-6","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T09:03:48Z","timestamp":1655888628000},"page":"98-106","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4919-7492","authenticated-orcid":false,"given":"Ximena A.","family":"Levander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canyon A.","family":"Foot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara L.","family":"Magnusson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan R.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerel M.","family":"Ezell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Feinberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian F.","family":"Go","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E.","family":"Lancaster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Salisbury-Afshar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon S.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan P.","family":"Westergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April M.","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith I.","family":"Tsui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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