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With around 70,000 women in England enduring €problem use€ of opiates, crack cocaine or both, a new study in the Journal of Advanced Nursing suggests that community healthcare professionals should recognise €the breadth of elevated sexual health risks and morbidities€ these women experience.

Researchers surveyed 77 women attending a substance misuse service in Hastings and Ore. Seventy-four per cent had used crack or heroin in the past two weeks and 39 per cent drank hazardous amounts of alcohol. Fifty-three per cent had been sexually active during the previous four weeks. During this time, 66 per cent had intercourse at least once that could have led to pregnancy. Just 29 per cent took oral contraceptives and, of these, 46 per cent missed at least one pill during the past month.

Overall, 43 per cent had a history of abnormal cervical cytology, 50 per cent had terminated at least one pregnancy and 55 per cent were forced to have sex against their will at least once. A third reported childhood sexual abuse.

During the previous year, 30 per cent were tested or received treatment for at least one sexually transmitted infection (gonorrhoea, chlamydia, genital warts or genital herpes). Overall, 87 per cent reported being screened for at least one of these STIs and 30 per cent had tested positive.

Pharmacists and other community healthcare professionals could refer women for STI and cervical screening, offer contraceptive advice, and help them €access counselling and support for related issues, such as sexual assault, child sexual abuse and intimate partner violence€.