The link between substance use and reproductive health service utilization among young US women

Background: The authors sought to investigate associations between young women's use of alcohol and other substances and their sexual and reproductive health (SRH) service utilization. Methods: The authors used data from 4421 young women aged 15-24 years in the nationally representative study, National Survey of Family Growth, 2002-2008. The authors examined associations between frequency of tobacco, alcohol, marijuana, and illicit drug use and SRH service use in the past year using logistic regression. Results: Over half (59%) of the young women used SRH services, including contraception (48%), gynecological examination (47%), and sexually transmitted infection (STI) testing/treatment (17%) services. Proportions of SRH service use increased with higher frequencies of substance use (all P values <.001); service use was particularly common among daily substance users (range: 72% of daily marijuana users to 83% of daily binge drinkers). In multivariable analyses, associations between substance and SRH service use varied by substance and service type: weekly marijuana (odds ratio [OR] = 2.5, 95% confidence interval [95% CI] = 1.4, 4.3, P =.002) and alcohol (OR = 1.7, 95% CI = 1.1, 2.4, P =.01) use were positively associated with gynecological service use. All substances were positively associated with STI service use. However, daily smoking was negatively associated with contraceptive service use (OR = 0.6, 95% CI = 0.4, 0.8, P =.001). Conclusion: SRH service use was common among women reporting frequent substance use. SRH settings provide an opportunity to deliver substance use screening and preventive care to young women.