• Skip to content
  • Skip to footer
  • Accessibility options
University of Brighton
  • About us
  • Business and
    employers
  • Alumni and
    supporters
  • For
    students
  • For
    staff
  • Accessibility
    options
Open menu
Home
Home
  • Close
  • Study here
    • Get to know us
    • Why choose Brighton?
    • Explore our prospectus
    • Chat to our students
    • Ask us a question
    • Meet us
    • Open days and visits
    • Virtual tours
    • Applicant days
    • Meet us in your country
    • Campuses
    • Our campuses
    • Our city
    • Accommodation options
    • Our halls
    • Helping you find a home
    • What you can study
    • Find a course
    • Full A-Z course list
    • Explore our subjects
    • Our academic departments
    • How to apply
    • Undergraduate application process
    • Postgraduate application process
    • International student application process
    • Apprenticeships
    • Transfer from another university
    • International students
    • Clearing
    • Funding your time at uni
    • Fees and financial support
    • What's included in your fees
    • Brighton Boost – extra financial help
    • Advice and guidance
    • Advice for students
    • Guide for offer holders
    • Advice for parents and carers
    • Advice for schools and colleges
    • Supporting you
    • Your academic experience
    • Your wellbeing
    • Your career and employability
  • Research
    • Research and knowledge exchange
    • Research and knowledge exchange organisation
    • The Global Challenges
    • Centres of Research Excellence (COREs)
    • Research Excellence Groups (REGs)
    • Our research database
    • Information for business
    • Community University Partnership Programme (CUPP)
    • Postgraduate research degrees
    • PhD research disciplines and programmes
    • PhD funding opportunities and studentships
    • How to apply for your PhD
    • Research environment
    • Investing in research careers
    • Strategic plan
    • Research concordat
    • News, events, publications and films
    • Featured research and knowledge exchange projects
    • Research and knowledge exchange news
    • Inaugural lectures
    • Research and knowledge exchange publications and films
    • Academic staff search
  • About us
  • Business and employers
  • Alumni, supporters and giving
  • Current students
  • Staff
  • Accessibility
Search our site
Research-project-banner
Research and knowledge exchange
  • Research and knowledge exchange
  • Postgraduate research degrees
  • Research features
  • Research organisation
  • Research environment
  • Groups
  • Healthcare Practice and Rehabilitation
  • Research projects
  • Modelling sexual healthcare for substance misusing women

Modelling sexual healthcare for substance misusing women

England’s National Strategy for Sexual Health and HIV had a requirement to improve sexual health service access that led to delivery innovations for target populations such as sex workers (outreach services) and intravenous drug users (IDUs) (provision of blood-borne virus testing in substance misuse services). General health assessment guidance from the National Treatment Agency for Substance Misuse includes sexually transmitted infection (STI) risk assessment (either directly or by referral) but excludes assessment of pregnancy risk.

The evidence base however suggests that a range of sexual health risks and morbidities are experienced not only by female injecting drug users (IDUs) but by substance-misusing women (SMW) as a whole (substance misuse in this context incorporating studies of female populations using variously crack cocaine, opioids and ‘illicit substances’). Studies indicate high risk of STIs, and of unintended pregnancy; and elevated sexual health risks including sexual assault, intimate partner violence and exchange of sex. Infrequent cervical screening and inconsistent condom and contraceptive use further suggest services have not been successfully provided.

Project objectives

Funded by the National Institute for Health Research 'Research for Patient Benefit' programme this study had two key aims, and corresponding stages.

In stage one, the study sought to identify sexual health risks and morbidities, and sexual health service use among substance-misusing women. Women aged 18+, residing in Hastings and Rother and who had used illicit or illegal substances in the previous month were invited to participate. Women were recruited at Hastings NHS Substance Misuse Service and Crime Reduction Initiative, and from Seaview Health and Wellbeing Centre in St. Leonard's on Sea. A combination of survey data and in-depth interview data were collected concerning:

  • type and frequency of sexual health risks and morbidities
  • levels of sexual health service use
  • enablers and barriers to that use among SMW
  • user preferences concerning sexual health service delivery

In stage two, the study sought to specify a model for optimal sexual healthcare delivery to substance misusing women. Using stage one findings and relevant policy documents a model was informally developed. This was then ‘tested’ on two panels of stakeholders to problem-solve difficult elements of the model, and to identify and resolve likely issues of feasibility and implementation.

Current and ex-service users collaborated on the study from its design through to dissemination - culminating in the production of a lay report made accessible to attendees at the recruitment sites, and in the co-presenting of an oral paper to the Society for Study of Addiction conference in November 2010.

Project impact

The study completed in June 2011. Locally, the findings have been presented to the Sussex drug practitioners' conference in 2011, to the Brighton Women’s Oasis conference in 2011 and to HIV and genitourinary medicine staff in Brighton. The latter groups have incorporated the recommendations of the study into new joint working practices and Hastings & Rother Primary Care Trust wrote the designed model into their sexual health commissioning plan.

Stage One interview findings were presented as an oral paper at the World Congress on Sexual Health in June 2011. A paper arising from the qualitative interviews has now been published in the Journal of Family Planning and Reproductive Health Care, while two further papers (concerning survey data and the modelling process) are being prepared for journal submission. Stage one data also indicated a particular need to investigate fertility management for this population – consequently a funding application to address this topic has been developed and is currently under review.

A range of practical, social and emotional barriers to sexual health service access exist for this population, presenting a context from within which use of services may come at considerable personal cost to SMW. Interventions addressing anticipated stigma and emotional, hygiene and fiscal concerns are warranted for this population.

Research team

Natalie Edelman

Dr Harish Patel

Dr Anthony Glasper

Leanne Bogen-Johnston

 

Output

Edelman, N, Patel, H, Glasper, A., Bogen-Johnston L (2014), Sexual health risks and health-seeking behaviours among substance-misusing women, Journal of Advanced Nursing, DOI: 10.1111/jan.12442

Commissioning Framework document (PDF)

Understanding barriers to sexual health service access among substance-misusing women on the South East coast of England

Partners

Seaview health and wellbeing project

The Hastings NHS Substance Misuse Service

The Crime Reduction Initiative.

Back to top
  • Facebook
  • X logo
  • Instagram
  • TikTok
  • YouTube
  • LinkedIn icon

Contact us

University of Brighton
Mithras House
Lewes Road
Brighton
BN2 4AT

Main switchboard 01273 600900

Course enquiries

Sign up for updates

University contacts

Report a problem with this page

Quick links Quick links

  • Courses
  • Open days
  • Explore our prospectus
  • Academic departments
  • Academic staff
  • Professional services departments
  • Jobs
  • Privacy and cookie policy
  • Accessibility statement
  • Libraries
  • Term dates
  • Maps
  • Graduation
  • Site information
  • Online shop
  • The Student Contract

Information for Information for

  • Current students
  • International students
  • Media/press
  • Careers advisers/teachers
  • Parents/carers
  • Business/employers
  • Alumni/supporters
  • Suppliers
  • Local residents