Analysis of sexual and reproductive health status in the context of homeless female substance abusers: a qualitative study

Homeless female substance abusers face extensive threats and challenges, particularly for their sexual and reproductive health. Therefore, identifying and understanding the experiences of this group is crucial for gaining effective insights into their sexual and reproductive health status. This study was conducted using a qualitative approach and conventional content analysis methodology. The study involved 19 participants, all of whom were homeless female substance abusers. Participants were recruited using purposive and snowball sampling techniques. Data were collected using semi-structured qualitative interviews and subsequently transcribed and coded using MAXQDA software. A total of 960 initial codes were extracted from the data analysis, and then classified into 19 subcategories and 5 main categories. The main categories include: disrupted family dynamics; the cycle of harm, insecure sexual-emotional partners, the free fall of a mother, sexually transmitted diseases (STDs), ominous uninvited guests, and social gaps: the platform of harm. Homeless women experience numerous stressful situations and conditions. These factors may have a direct or indirect impact on their sexual, as well as mental health. Therefore, policymakers and service providers need to adopt a comprehensive view in delivering equitable measures and services for these individuals by addressing both prevention and rehabilitation.