Assessing the provision of contraception in a novel sexual health service for the Homeless

Assessing the provision of contraception in a novel sexual

health service for the Homeless

T.M. Groom, A. McLellan, M. Kennedy, A.H. Brown

Sandyford Initiative, Glasgow, UK

Background A sexual health

service dedicated to the homeless commenced in August 2004, aiming to provide a

flexible, accessible service to the homeless clients at a range of sites across

the city.

Objective To examine the contraception type issued during the first

year of this service; the number of clients receiving contraception

opportunistically and the proportion of clients attending for follow up.


Case notes and electronic records of all female clients, who received a

prescription for contraception between August 2004 and July 2005, were examined.

Data regarding reason for attendance, type of contraception issued, and follow

up was recorded. Information regarding a history of addiction, sexual and

domestic violence, and prostitution was also recorded.

Results Forty-four women

(average age 25 yrs) received contraception. 16(39%) women had a history of

Intravenous Drug Use (IVDU), 16(38%) women had a history of alcoholism,7(17%)

had been or were involved in prostitution, 26(62%) had experienced sexual

violence and 19(46%) domestic violence. Twenty-one women attended specifically for

contraception and 23 were prescribed it opportunistically. Long acting

reversible contraception (LARC) was issued to 34/44 (77%). 81% of women affected

by IVDU and 100% of women involved in prostitution accepted LARC. Implanon users

had been affected by IVDU in 5(29%) of cases, alcoholism in 4(23.5%), sexual

violence in 8(47%), domestic violence in 9(53%),and prostitution in 3 (18%) of

cases Clients who were issued with Implanon (17) were most likely to attend for

follow up (65%) compared to 56% for women receiving other long acting methods,

and 50% of those receiving other methods.

Conclusion Homeless women are

affected by complex issues which may make regular clinic attendance difficult.

The majority of our clients accept long acting reversible contraceptive methods.

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