Barriers and Facilitators to Sexual and Reproductive Healthcare for Women in Opioid Use Disorder Recovery: Perspectives from Recovery Healthcare Professionals

Objective: Women in recovery from opioid use disorder (OUD) experience sexual and reproductive health disparities which worsen health outcomes and may negatively impact recovery. While in recovery programs, women engage with different healthcare professionals, but how these professionals provide sexual and reproductive healthcare (SRH) is not well known. The purpose of this study is to identify perceived barriers and strategies to overcome barriers to providing SRH to women in recovery from OUD from the perspective of OUD recovery healthcare professionals. Methods: Guided by the social ecological framework, we used a qualitative descriptive study design to conduct individual semi-structured interviews with healthcare professionals (nurses, doctors, leaders/managers, peer support specialists, therapists, and case managers). Data was analyzed using thematic analysis. Results: Among individual interviews with N = 34 healthcare professionals, we identified two overarching themes: Barriers and Facilitators. Barriers included unmet provider training needs, navigating patient stigma and shame surrounding SRH, and fragmented healthcare systems. Facilitators included leveraging communities of shared experiences and developing ideal models of SRH programming. This included co-location of SRH and recovery spaces and the importance of peer support specialists in women’s recovery journeys. Conclusions: Multi-level challenges to address SRH in recovery require discipline specific training of healthcare professionals, empowering peer professionals, and policy and advocacy to address systemic issues.