Article Text

Download PDFPDF

Understanding barriers to sexual health service access among substance-misusing women on the South East coast of England
  1. Natalie Lois Edelman1,
  2. Harish Patel2,
  3. Anthony Glasper3,
  4. Leanne Bogen-Johnston4
  1. 1Senior Research Fellow, Centre for Health Research, University of Brighton, Falmer, UK
  2. 2Consultant in Genitourinary Medicine, Hastings Sexual Health Clinic, Hastings & Rother Primary Care Trust, Hastings, UK
  3. 3Clinical Director for Substance Misuse Services, Hastings Substance Misuse Service, Sussex Partnership NHS Foundation Trust, Hastings, UK
  4. 4Research Fellow, Research and Development, Sussex Partnership NHS Foundation Trust, Brighton and Hove, UK
  1. Correspondence to Ms Natalie Lois Edelman, Centre for Health Research, University of Brighton, Room 262 Mayfield House, Village Way, Falmer, East Sussex BN1 9PH, UK; N.Edelman{at}


Objectives Evidence suggests substance-misusing women (SMW) experience disproportionate sexual health morbidity and poor uptake of interventions including contraception and cervical screening, yet there has been little investigation of sexual health service access issues for this population.

Methods Twenty women with problem drug use in Hastings in South East England, UK participated in a one-to-one interview with a researcher to explore experiences and beliefs surrounding access to a range of sexual health service interventions. Transcripts were open-coded and themes were elicited and organised concerning barriers to access.

Results Drug-use lifestyles, trauma and low self-worth framed the lives of SMW and hindered sexual health service access through: depleted practical and emotional resources to enable attendance; high perceived emotional cost of discussing sexual histories, and coping with tests and unfavourable results; and low anticipated value of sexual health interventions due to low perception and minimisation of risk and perceived incompatibility between drug use and sexual well-being.

Conclusions 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.

  • cervical screening
  • genitourinary medicine
  • service delivery
  • sexually transmitted infections
  • contraception
View Full Text

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Highlights from this issue
    British Medical Journal Publishing Group