This RTI study was grounded in social-cognitive theory and aimed to develop and initially evaluate an intervention, Sex and Female Empowerment (SAFE), designed to increase acceptance of and adherence to contraceptive practices among opioid-agonist-maintained women of childbearing age. The intervention was developed and efficacy was compared between two different formats: face-to-face and novel computer-adaptive platform. SAFE has the potential to reduce the number of unintended pregnancies and consequently decrease the need for and the costs of child protective services. Improving women’s ability to make and adhere to contraceptive choices and better time their pregnancies while also decreasing risky sexual behavior that can lead to HIV and other sexually transmitted infections (STIs) add to the promise of this intervention's potential overall public health impact.