Theme: Social Science & Policy Research Year: 2024
Background: Pregnant people who use unregulated drugs (PPWUD) face increased risk of health and social harms, such HIV, hepatitis C, and criminalization, compared to other people who use drugs. Access to sexual and reproductive health (SRH) services may reduce some harms. Yet, PPWUD encounter many barriers to engaging with SRH services, including limited availability of targeted SRH services. Little is known about the types of SRH programs that support the health of PPWUD. This presentation aims to identify and describe existing SRH programs for PPWUD in Canada, including facilitators of access, and to examine future actions to best support PPWUD.
Methods: A scoping review was conducted using JBI methodology. Scholarly databases and grey literature sources were searched to identify texts from 2016-2023 that discussed, conceptualized, or evaluated policies, programs and practices that support PPWUD’s access to SRH services in Canada. Literature was screened using Covidence. Data were extracted and analyzed descriptively for key frequencies and concepts.
Results: A total of 71 texts were included, representing 46 unique SRH programs. Most programs were located in urban areas. Many programs offered holistic ‘wrap-around services’ including health, social, cultural and family services, which supported access. Most frequent program outcomes included keeping families together, improving connections to other services, and reducing substance-related harms. Noted helpful practices included providing non-judgmental care and using harm reduction strategies.
Conclusion: This review provides insight into practices which support the health of PPWUD and which could be replicated in other settings. However, although it appears that many SRH programs exist in Canada, the scope of SRH services is narrow and there has been limited evaluation of client experiences within these programs. Moving forward, the scope of services must be expanded to fully support the reproductive rights of PPWUD, support gender diverse PPWUD and their intimate partners, and to serve rural and remote communities.
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