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. 2020 Mar 30;15(3):e0230886.
doi: 10.1371/journal.pone.0230886. eCollection 2020.

Gender-based vulnerability in women who inject drugs in a harm reduction setting

Jorge Valencia  1   2 , Alejandro Alvaro-Meca  3 , Jesús Troya  4 , Jorge Gutiérrez  2 , Cristina Ramón  2 , Antonio Rodríguez  2 , Sonia Vázquez-Morón  5   6 , Salvador Resino  6 , Santiago Moreno  7 , Pablo Ryan  4   8   9
Affiliations

Gender-based vulnerability in women who inject drugs in a harm reduction setting

Jorge Valencia et al. PLoS One. .

Abstract

Background and aims: In comparison with men, women who use drugs (WWUD) have considerably more frequent and intense experiences with interpersonal violence, sexual abuse and trauma. The aim of this study was to identify issues related to gender-based vulnerability in a group of WWUD attended in a harm reduction facility in Madrid, Spain.

Material and methods: A cross-sectional study was conducted during a screening of blood borne infections. We included WWUD (smoked or injected heroin/cocaine) who were actively screened for HIV, HBV and HCV in a harm reduction setting in Madrid (Spain) from January to December 2017. WWUD were interviewed for gender-based abuse or violence using a face-to-face questionnaire by a trained interviewer. Aspects related to their social-epidemiological condition and gender-based vulnerability were collected.

Results: We included 109 women who were actively using drugs. The median age was 39 (IQR 35-47) years, 84.4% were Spanish born, 22.9% were homeless, 43 (41.7%) had ever used injected drugs, 29 (26.6%) were currently using injected drugs, and 27.1% had mental health disorders. Aspects related to gender-based vulnerability were collected. Among those surveyed, they reported having ever suffered emotional or psychological damage (88%), having experienced at least one incident of serious physical injury by a male partner (71%), and having ever suffered sexual abuse (49%). In addition, 28% had ever exchanged sex for money/drugs. When compared to women that did not use injecting drugs, those who injected drugs had more frequently exchanged sex for money/drugs (55% vs 21%, p = 0.003).

Conclusions: A high proportion of WWUD suffer psychological or physical violence by partners denoting gender-based vulnerability. Interventions in harm reduction settings with a multidisciplinary and gender-based approach should be implemented.

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Conflict of interest statement

This work has been funded by a research grant from Merck Sharpe & Dohme (MISP IIS#54846). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

References

    1. Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. The Lancet Global Health. 2017;5(12):e1192–e207. 10.1016/S2214-109X(17)30375-3 - DOI - PMC - PubMed
    1. Azim T, Bontell I, Strathdee SA. Women, drugs and HIV. International Journal of Drug Policy. 2015;26:S16–S21. 10.1016/j.drugpo.2014.09.003 - DOI - PMC - PubMed
    1. Lansky A, Finlayson T, Johnson C, Holtzman D, Wejnert C, Mitsch A, et al. Estimating the number of persons who inject drugs in the United States by meta-analysis to calculate national rates of HIV and hepatitis C virus infections. PloS one. 2014;9(5):e97596 10.1371/journal.pone.0097596 - DOI - PMC - PubMed
    1. Evans JL, Hahn JA, Page-Shafer K, Lum PJ, Stein ES, Davidson PJ, et al. Gender differences in sexual and injection risk behavior among active young injection drug users in San Francisco (the UFO Study). Journal of Urban Health. 2003;80(1):137–46. 10.1093/jurban/jtg137 - DOI - PMC - PubMed
    1. Morris MD, Evans J, Montgomery M, Yu M, Briceno A, Page K, et al. Intimate injection partnerships are at elevated risk of high-risk injecting: a multi-level longitudinal study of HCV-serodiscordant injection partnerships in San Francisco, CA. PloS one. 2014;9(10):e109282 10.1371/journal.pone.0109282 - DOI - PMC - PubMed

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