Joy Scheidell is an epidemiologist whose research examines intersections among substance use and sexual and reproductive health, with a specific focus on gender and racial/ethnic minority groups.

Introduction: Women who use illicit opioids have elevated risk for adverse sexual and reproductive health (SRH) outcomes including sexually transmitted infections (STIs) and sequelae, and high burden of unmet SRH care need. Syringe service programs (SSPs) may be a venue to reach women with SRH care.
Methods: From November 2021 to August 2022, within a cohort study among people who use illicit opioids in New York City, we conducted a substudy in which 119 participants completed a survey assessing SRH conditions and care, including those received at SSPs, and we estimated the prevalence among those who identified as women (N=50) overall and by race/ethnicity.
Results: The sample average age was 45 years (range 20-66). Approximately 28% were White, 32% Black, and 40% Hispanic/Latina. White women reported higher prevalence of STI symptoms (43%) and receipt of testing (21%) in the past year, while Black and Hispanic/Latina women reported higher prevalence of STI diagnosis (~8%); only half of Hispanic/Latina women received treatment. Over 80% of Black and Hispanic/Latina women reported using no/ineffective STI prevention and half had problems getting feminine hygiene products. About 50% of White and Hispanic/Latina women went to an SSP in the past year versus 25% of Black women; among women who went, receipt of SRH services (e.g., safer sex education: ~40%, pregnancy/infectious disease testing: ~20%) was similar across race/ethnicity. One-quarter of Hispanic/Latina women believed onsite SRH care at SSPs could address stigma compared to half of White and Black women, while the majority felt comfortable receiving SRH services from a clinic run by an SSP regardless of race/ethnicity.
Conclusion: Integrating SRH care at SSPs could increase access and improve health for women who use illicit opioids. Racial/ethnic differences in SRH experiences will require tailoring and targeting of services, while also identifying ways to reach women through other venues.