Contraception and Clean Needles: Feasibility of Combining Mobile Reproductive Health and Needle Exchange Services for Female Exotic Dancers

At the time of the study, Eva Moore was with the Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD. Jennifer Han, Christine Serio-Chapman, Cynthia Mobley, and Catherine Watson are with the Baltimore City Health Department. Mishka Terplan is with the Department of Obstetrics, Gynecology, and Reproductive Sciences and the Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore.
American Journal of Public Health (Impact Factor: 4.55). 08/2012; 102(10):1833-1836. DOI: 10.2105/AJPH.2012.300842
Source: PubMed


Young women engaged in exotic dancing have a higher need for reproductive health services than women not in this profession, and many also use drugs or exchange sex for money or drugs. Few report receiving reproductive health services. We describe a public health, academic, and community partnership that provided reproductive health services on needle exchange mobile vans in the "red light district" in downtown Baltimore, Maryland. Women made 220 visits to the vans in the first 21 months of the program's operation, and 65% of these visits involved provision of contraception. Programmatic costs were feasible. Joint provision of needle exchange and reproductive health services targeting exotic dancers has the potential to reduce unintended pregnancies and link pregnant, substance-abusing women to reproductive care, and such programs should be implemented more widely.

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Available from: Mishka Terplan, Sep 01, 2014
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    • "Discrimination of IDUs remains high in China, and many IDUs expressed reluctance to attend harm reduction centers due to the lack of confidentiality and fear that others would discover their status as a drug user [18], [43], [47], [48]. Some programs have tried to address issues of confidentiality by having mobile vans serve as NEPs, or even NGO-members who carry clean needles in their backpacks and go directly to the houses of drug users to exchange needles [21], [22], [49]. Others also feared arrest and harassment by police who might identify them through their attendance at harm reduction services. "
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    ABSTRACT: Objectives: We describe depot medroxyprogesterone acetate (DMPA) continuation patterns among female exotic dancers receiving reproductive health services at a mobile syringe exchange. Methods: Clients initiating DMPA between November 2009 and August 2012 were identified retrospectively via chart review. Life table analysis measured continuation. Client characteristics were compared using chi-square tests. Results: Sixty nine clients were identified; 72% were African American and 63% were younger than 25. At three months, 36% of the study sample continued DMPA; those continuing were more likely to be White (p=0.01) and receive other services (p=.01). The 12-month cumulative continuation probability was 0.09. Considering those who had received an injection, continuation proportions were higher (46% at 6; 71% at 12 months). Conclusions: A subset of female exotic dancers may favor DMPA as a long term contraceptive. Integrating mobile reproductive health services into public health programs can help fulfill the unique health needs of this high-risk population.
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