Linkage Matters: Integrating Sexual and Reproductive Health and Substance Use Treatment.

Abstract

Introduction: Sexual and reproductive health (SRH) is a critical component of overall well-being, yet individuals with substance use disorder (SUD) often face significant barriers to accessing SRH services-and vice versa. SRH settings offer important opportunities to identify and address SUD needs through screening and referral, whereas SUD treatment settings can serve as key access points for SRH care. The Link Study was developed as a cross-training intervention to strengthen collaboration and care coordination between SRH and SUD providers.

Methods: We designed a curriculum covering core elements of SRH and SUD care, emphasizing person-centered practices, trauma-informed approaches, and evidence-based screening and referral tools. Thirty-five providers from three SRH and SUD site pairs participated. Evaluation included pre- and post-training knowledge surveys, site-level screening and referral data, and provider focus groups. We used confidence intervals to assess changes in quantitative outcomes and conducted thematic analysis of qualitative data.

Results: Providers demonstrated consistent increases in self-reported knowledge across key domains. Two of the three SRH and SUD sites showed statistically significant improvements in screening practices. Although referral rates did not change significantly, sites reported meaningful updates to workflows, tools, and policies to support integration. All sites sustained cross-sector provider relationships for at least 6 months post-training.

Discussion: The Link Study showed promising gains in provider knowledge, improvements in screening practices, and lasting collaboration across SRH and SUD service sectors. Findings highlight the potential of cross-disciplinary training and technical assistance to build integrated care pathways and strengthen community-based health systems.