Exploring Family Planning Perspectives Among Men Receiving Medications for Opioid Use Disorder: Implications for Service Development.

OBJECTIVE: Studies have consistently found high rates of unintended pregnancy among women with substance use disorder. While research efforts have begun to focus on understanding needs and providing family planning services for women in treatment, few studies have included men. This has resulted in a gap in the literature regarding men's reproductive health experiences and family planning desires. METHODOLOGY: Between December 2019 and February 2020, we conducted semistructured qualitative interviews with adult men receiving medications for opioid use disorder at a safety-net healthcare system in Denver, Colorado. Interviews were recorded and analyzed using the Rapid Assessment Process. RESULTS: Fifteen men participated in an interview. Overall, men described feeling excluded from family planning education and services as well as from decision making with their partners. Participants desired knowledge and resources related to contraceptive methods, partner communication, and parenting. Additional themes included loss of autonomy around pregnancy decisions, the importance of fatherhood, and the importance of addressing family planning during recovery. Participants expressed interest in a family planning intervention but indicated that engaging men on this topic may be challenging. CONCLUSIONS: Our findings suggest that men in treatment desire education and involvement in family planning. Participants endorsed access to a subject expert within the treatment environment, but engagement strategies that underscore topic relevance to men will be critical. Initiating a conversation involving education and service navigation in the treatment setting may be a promising strategy for engaging men in recovery in family planning and improving men's access to needed services and resources.

Prevalence of adverse childhood experiences and post traumatic stress disorder symptoms in a primary care safety-net population: Implications for healthcare service needs.

OBJECTIVE: We characterized the prevalence and associated characteristics of Adverse Childhood Experiences (ACEs) and Post-traumatic stress disorder (PTSD) in a safety net system and assessed patient preferences for trauma informed care. METHODS: We performed a cross-sectional survey among adult patients attending primary care at three urban federally qualified healthcare centers. We used a method of recruitment that included both convenience and systemic sampling. The survey included the ACEs Questionnaire, the PTSD for DSM 5 (PC-PTSD5), and trauma-informed care preferences. We accessed Electronic Health Records for demographic and clinical data. We used descriptive and multivariable statistical analyses. RESULTS: 303 of 481 (63%) patients that were approached participated. Most participants (81%) had one or more ACEs and 38% had four or more. 88 (29%) patients screened positive for current PTSD. ACEs was associated with a diagnosis of mental illness (p = 0.0125) and substance use disorders (p = 0.01). Patients with ACEs >/=4 or positive PC-PTSD reported stress in attending medical visits and that trauma-informed provider behaviors would make their visits less stressful. CONCLUSIONS: Rates of ACES and current PTSD symptoms were high in this population and support the need for research to evaluate universal trauma-informed care strategies for safety-net healthcare systems.