Risky Sexual Behaviours and Knowledge on Contraceptive Use and Family Planning Among Women Who Use Drugs (WWUDs) in Malaysia

Women who use drugs (WWUDs) face elevated risk of intimate partner violence (IPV) and unsafe sexual behaviours. This prevalence study, involving 200 WWUDs in a mandated drug rehabilitation program, examined risky sexual behaviours, family planning knowledge among IPV victims, and barriers to contraceptives or condoms use. The majority were Malays (86%, n = 171/200), averaging 32.3 years of age (SD = 8.61). Over half had experienced IPV in their lifetime (53%, n = 105/200). IPV victims had higher odds of unwanted pregnancies, prior abortions, concurrent drug use with partners, drug use before sex, and cohabitation with male partners who used drugs. Sixty percent were uninformed of female condoms, and most disliked using male condoms due to performance concerns. Despite better family planning knowledge among IPV victims, WWUDs had limited awareness of contraceptive use. Interventions should prioritize empowering and educating WWUDs, particularly IPV victims, on IPV prevention and the risks associated with unsafe sexual behaviour during rehabilitation.