ArticleWomen's health (London, England)
Patient and provider perspectives on barriers and facilitators to reproductive healthcare access for women experiencing homelessness with substance use disorders in San Francisco.
Article in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 15 citations in OpenAlex.
- Personality disorders and related healthcare use among older United States veterans experiencing housing instability and homelessness, 2016-2024.GeroScience · 2026Article
- Examining buprenorphine compared to methadone for likelihood of overdose during pregnancy, 2014-2021.Pregnancy (Hoboken, N.J.) · 2026Article
- The Experiences of Service Providers Who Care for Homeless Pregnant or Early Parenting Women.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2026Article
- Evidence mapping on barriers in accessing prenatal healthcare services among homeless women: a scoping review.BMC health services research · 2025Article
- "I feel like people would look at me like I'm dirty or like I'm a thief:" a qualitative exploration of interpersonal and intrapersonal experiences that influence recovery among adults at risk of opioid-related overdose.Frontiers in public health · 2025Article
- Interest in digital health tools for miscarriage support: A qualitative assessment of Canadian women facing early pregnancy loss.Women's health (London, England)Article
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWomen experiencing homelessness with substance use disorders face unique and intersecting barriers to realizing their reproductive goals.
objectiveThis study explored the reproductive aspirations of this population, as well as the barriers to accessing reproductive services from the perspectives of affected individuals, and the healthcare providers who serve them.
designThis mixed-methods study included surveys and interviews with women experiencing homelessness with substance use disorders and healthcare providers.
methodsWe conducted surveys and semi-structured interviews with women recruited from opiate treatment programs and homeless encampments in San Francisco, California in 2018. We also conducted interviews and focus groups with healthcare providers in reproductive health and substance use treatment settings. Interviews were recorded, transcribed, and coded. Descriptive statistics of survey results were performed.
resultsTwenty-eight women completed surveys, 96% of whom reported current substance use. Ten women participated in interviews. One-third (9/28) reported desiring pregnancy in the next year; over half (16/28) reported they would be somewhat or very happy to learn they were pregnant. A majority used no contraception at last intercourse (14/28). Twenty-six healthcare providers participated in interviews (n = 15) and focus groups (n = 2). Patients and providers identified similar barriers to care access, including discrimination, logistical and financial challenges, and delayed pregnancy awareness. While providers proposed solutions focused on overcoming logistical challenges, patients emphasized the importance of transforming the healthcare environment to treat patients affected by substance use and homelessness with dignity and respect.
conclusionWomen experiencing homelessness with substance use disorders face intersecting and compounding barriers to accessing reproductive health services. For patients, the impact of stigma and bias on treatment experiences are particularly salient, in contrast to logistical barriers emphasized by providers. Improving access will require structural and individual-level solutions to address stigma and create person-centered, trauma-informed, and respectful care environments.
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