Women in Recovery April R Vince MSSA LSW

Women in Recovery April R. Vince MSSA, LSW & Brittani Flory BSN, RN Cuyahoga County Board of Health September 2020

History • Pilot Project started in 2016 • Established relationship with recovery house • Partnered with our Title X clinic at The Cuyahoga County Board of Health

Facts • Women with opioid and other drug addiction often have misconceptions about birth control options and other reproductive health options • This can lead to: o Higher rate of unintended pregnancies o Higher rate of STI’s o Higher rates of cervical cancer

How the program works • Initial group education session occurs in the residential facility. This addresses: o o Birth rates and outcomes for women and addiction Birth control options Education on STI’s Healthy relationships • Immediately after the session, the women are given the option for STI testing, WWE, and Birth Control at CCBH

What happens at the group sessions at CCBH? • Education sessions and CCBH appointment typically occur monthly. o Education—we tried to do every Thursday before the testing day. o Meant to be very informal! Everyone is ages 18 -60. o At the beginning of every session the staff introduce themselves, give a brief overview about CCBH and Title X and describe our program. o Sign in sheet o 3 part session • Session 1: Intro discusses the program why women are at risk, then overview when to get Paps and mammograms and STDs overview • Session 2: Birth control: LARC first • Session 3: HIV/Hep C o At end of every session • Sheet for the ladies to sign up for appointments if they want one for any reproductive health reason • Appointments Tuesday AM 9: 30 o Usually try for 6 women

Continued… • At our Parma location we are able to offer group appointments where they are able to obtain all of their desired Title X services • Group support for each other • One on One discussion of lab results • Referral services if needed

Overview of 2018 • • 65 women educated, 35 came in for an office visit 25 received rapid HIV screening 33 received Chlamydia/Gonorrhea screening 32 opted to come in for a well visit, which included Pap smear • 37% reported history of sexual assault • 70% sought long acting reversible contraceptive (IUD or implant) • Also screened for Hep C, referrals for mammograms, HPV vaccines, Hep A & B vaccines, preconception counseling and prenatal vitamins

2019 & 2020 • We were able to expand a similar model to another recovery facility in Cuyahoga County. • Expanded education services to recovery facilities. • Have seen many returning clients in office from previous facilities. • Total to date we have seen 187 patients through this model.

Future steps • Continue to provide education, testing and appointment referrals for the women at facilities • Continue to grow and adapt to the needs of the women • Continue to gather data about reproductive health, stigma, health care barriers, and empowerment of women experiencing addiction and in recovery • Expand to other women’s recovery centers around the Greater Cleveland area • Possible future support through CDC funding

Questions? April R. Vince MSSA, LSW avince@ccbh. net 216 -201 -2001, ext. 1538 Brittani Flory BSN, RN bflory@ccbh. net 216 -201 -2001, ext. 1316