1
|
Carrillo Beck R, Szlapinski J, Pacheco N, Sabri Laghaei S, Isard R, Oudshoorn A, Marshall CA. Violence and victimisation in the lives of persons experiencing homelessness who use methamphetamine: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1619-1636. [PMID: 35032080 DOI: 10.1111/hsc.13716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/30/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Methamphetamine (MA) use among individuals who experience homelessness has tripled in recent years. This is a problematic trend given the harmful impacts of this substance on health and social well-being. While there is a large body of literature on the relationship between substance use and trauma, little is known about the scope of existing empirical literature exploring this topic related to MA use. Anecdotally, MA is frequently associated with violence and victimisation, which may be related to stigma associated with using MA. However, little is known about the scope of empirical literature exploring violence and victimisation in the lives of individuals who experience homelessness and use MA. We conducted a scoping review to fill this gap in existing literature using Arksey and O'Malley's methodological framework. Our search was conducted between January 2021 and March 2021 and was deployed in seven databases: Medline, Embase, CINAHL, PsycINFO, Sociological Abstracts, Nursing and Allied Health and AMED. Two independent raters screened 700 titles and abstracts after the removal of duplicates. A total of 54 articles were subjected to a full-text review and 20 articles met the inclusion criteria. We generated two themes: methamphetamine and victimisation and challenging behaviours. Six (30%) of the included articles explored MA use in relation to violence, while 18 (90%) explored experiences of victimisation among persons experiencing homelessness. Our findings highlight that individual who experience homelessness and use MA are particularly vulnerable to experiences of trauma. Though existing literature does acknowledge the challenging behaviour associated with MA use, only three existing studies demonstrated a relationship between MA use and physical violence. Research exploring the impacts of MA use on victimisation among persons who experience homelessness, and the development of interventions for managing challenging behaviours associated with MA use are needed.
Collapse
Affiliation(s)
- Rozelen Carrillo Beck
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, London, Ontario, Canada
| | - Jessica Szlapinski
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, London, Ontario, Canada
| | - Nicole Pacheco
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, London, Ontario, Canada
| | - Shahriar Sabri Laghaei
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, London, Ontario, Canada
| | - Roxanne Isard
- Weldon Library, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- School of Nursing, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- Social Justice in Mental Health Research Lab, Faculty of Health Sciences, School of Occupational Therapy, London, Ontario, Canada
| |
Collapse
|
2
|
Negative urgency moderates the association between compulsive sexual behaviors and sending unsolicited sexts among men in residential treatment for substance use disorders. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
3
|
Jawa R, Stein MD, Anderson B, Liebschutz JM, Stewart C, Phillips KT, Barocas JA. Behavioral Risk Factors for HIV Infection in Hospitalized Persons Who Co-use Stimulants and Opioids. AIDS Behav 2022; 26:1047-1055. [PMID: 34510289 PMCID: PMC8435119 DOI: 10.1007/s10461-021-03460-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 01/03/2023]
Abstract
We investigated the association of 90-day opioid and stimulant co-use and HIV risk behaviors in a cross-sectional analysis of hospitalized HIV-negative people who inject drugs (PWID). We compared those injecting opioids alone to two sub-groups who co-used opioids with (1) cocaine, (2) amphetamine-type stimulants (ATS), on sex and injection drug risk behaviors assessed via the Risk Assessment Battery (RAB), where a higher score indicates a higher risk. Of 197 participants who injected opioids, 53% co-used cocaine only, 5% co-used ATS only, 18% co-used both cocaine and ATS, 24% co-used neither stimulant. PWID who injected opioids alone had a mean RAB drug risk score of 5.98 points and sex risk score of 2.16 points. Compared to PWID who injected opioids alone, PWID who co-used stimulants had higher mean drug risk RAB scores: cocaine, b = 2.84 points [95% confidence interval (CI) 1.01; 4.67]; ATS, b = 3.43 points (95% CI 1.29; 5.57). Compared to PWID who injected opioids alone, cocaine co-use was associated with higher sex RAB scores b = 1.06 points (95% CI 0.32; 1.79). Overall, we found a significant association between stimulant co-use and higher HIV sex and drug risk scores.
Collapse
Affiliation(s)
- Raagini Jawa
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA.
- Boston University School of Medicine, Boston, MA, USA.
| | - Michael D Stein
- Boston University School of Public Health, Boston, MA, USA
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Bradley Anderson
- Behavioral Medicine and Addictions Research, Butler Hospital, Providence, RI, USA
| | - Jane M Liebschutz
- Division of General Internal Medicine, Center for Research On Health Care, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kristina T Phillips
- Center for Integrated Health Care Research, Kaiser Permanente Honolulu, Honolulu, HI, USA
| | - Joshua A Barocas
- Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Ave, 2nd Floor, Boston, MA, 02118, USA
- Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
4
|
Strathdee SA, Bristow CC, Gaines T, Shoptaw S. Collateral Damage: A Narrative Review on Epidemics of Substance Use Disorders and Their Relationships to Sexually Transmitted Infections in the United States. Sex Transm Dis 2021; 48:466-473. [PMID: 33315749 PMCID: PMC8184578 DOI: 10.1097/olq.0000000000001341] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Associations between substance use disorders and outbreaks of HIV and acute viral hepatitis have received considerable attention, but less research has focused on links between substance use disorders and sexually transmitted infections, apart from alcohol misuse. This narrative review describes the history of this public health crisis in the United States and direct and indirect effects opioids and specific stimulants have on high-risk sexual behaviors. We also review the epidemiology of sexually transmitted infections associated with opioids and stimulants in the United States and discuss opportunities for integrated interventions.
Collapse
Affiliation(s)
- Steffanie Ann Strathdee
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Claire C Bristow
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Tommi Gaines
- From the Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla
| | - Steven Shoptaw
- Department of Family Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| |
Collapse
|
5
|
Shimane T, Takahashi M, Kobayashi M, Takagishi Y, Takeshita Y, Kondo A, Omiya S, Takano Y, Yamaki M, Matsumoto T. Gender Differences in the Relationship between Methamphetamine Use and High-risk Sexual Behavior among Prisoners: A Nationwide, Cross-sectional Survey in Japan. J Psychoactive Drugs 2021; 54:9-17. [PMID: 33977855 DOI: 10.1080/02791072.2021.1918805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to examine the relationship between methamphetamine (MA) use and high-risk sexual behavior among newly incarcerated prisoners in Japan. We conducted a secondary analysis using cross-sectional survey data, which constituted a nationwide prison sample surveyed between July and November 2017. In total, 699 participants (462 male and 237 female prisoners), who completed the self-administered questionnaire during imprisonment were recruited for the study. The prevalence of high-risk sexual behaviors was as follows: inconsistent condom use (78.4% male, 81.7% female), multiple sexual partners (61.3% male, 41.3% female), history of sexually transmitted diseases (14.1% male, 23.6% female), and trading sex for drugs (15.6% male, 17.7% female). A logistic regression analysis showed that MA use during sex increased the likelihood of high-risk sexual behavior in both male (adjusted odds ratio [AOR] = 5.86; 95% confidence interval [CI] = 3.41-10.07) and female prisoners (AOR = 2.58; 95% CI = 1.33-5.00). Additionally, in female prisoners, a history of sharing MA injection (AOR = 1.60; 95% CI = 1.06-2.42) increased high-risk sexual behavior. Our results indicate that harm reduction programs tailored according to the specific necessities of each gender to reduce high-risk sexual behaviors among MA users should be included in Japanese drug policies.
Collapse
Affiliation(s)
- Takuya Shimane
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Masaru Takahashi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Ochanomizu University, Tokyo, Japan
| | - Michiko Kobayashi
- Research Department, Research and Training Institute, Ministry of Justice of Japan, Urayasu, Chiba, Japan
| | - Yuriko Takagishi
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Psychology, Surugadai University, Saitama, Japan
| | - Yoshiko Takeshita
- Kawagoe Juvenile Prison, Ministry of Justice of Japan, Saitama, Japan
| | - Ayumi Kondo
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Soichiro Omiya
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Joetsu University of Education, Niigata, Japan
| | - Youichi Takano
- Yokohama Prison, Ministry of Justice of Japan, Kanagawa, Japan
| | - Mayuko Yamaki
- Training Institute for Correctional Personnel, Ministry of Justice of Japan, Tokyo, Japan
| | - Toshihiko Matsumoto
- Department of Drug Dependence Research, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| |
Collapse
|
6
|
Stockman JK, Syvertsen JL, Hayashi HD, Ludwig-Barron N, Tsuyuki K, Morris MD, Palinkas LA. "Violence and love and drugs…it all goes hand in hand": A mixed methods analysis of the substance abuse, violence, and HIV/AIDS syndemic among women who use methamphetamine. Subst Abus 2021; 42:821-831. [PMID: 33492198 PMCID: PMC8442613 DOI: 10.1080/08897077.2020.1865242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The synergistic epidemics of substance use, violence, and HIV/AIDS, also known as the SAVA syndemic, disproportionately affects vulnerable women in the United States. Methamphetamine use is closely linked with physical and sexual violence, including intimate partner violence (IPV), which heightens women's vulnerability to HIV. This mixed methods study examined the prevalence and correlates of violence among women who use methamphetamine, (n = 209) enrolled in an HIV intervention study in San Diego, California. Methods: At baseline, 209 women completed an interviewer-administered computer-assisted survey. A sub set of women who reported lifetime IPV (n = 18) also participated in qualitative interviews to contextualize our understanding of patterns of violence over time. Results: In the overall cohort, reports of lifetime (66.0%) and past 2-month (19.6%) IPV were prevalent. Moreover, women reported lifetime physical only (27.3%), sexual only (6.2%), or both forms of violence (50.7%) by multiple perpetrators. Factors independently associated with lifetime IPV were having unprotected sex with a steady partner (odds ratio [OR]: 2.50, 95% confidence interval [CI]: 1.04, 6.00) and being high on methamphetamine during unprotected sex with a steady partner (OR: 2.56, 95% CI: 1.30, 5.09) within the past 2 months. Our qualitative narratives illuminated how IPV in women's steady relationships often reflects a culmination of violent victimization throughout their lifetime which is further exacerbated by methamphetamine use and sexual risk through gendered power dynamics. Conclusions: HIV prevention interventions should address the SAVA syndemic in a holistic manner, including the role of methamphetamine use in the context of women's abusive steady relationships.
Collapse
Affiliation(s)
- Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | | | - Hitomi D. Hayashi
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA
| | - Natasha Ludwig-Barron
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Kiyomi Tsuyuki
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Meghan D. Morris
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | | |
Collapse
|
7
|
Recent Partner Violence, Sexual Relationship Power, and STIs among Women Who Use Methamphetamine: Does Type of Sexual Partner Matter? J Urban Health 2020; 97:387-394. [PMID: 32232654 PMCID: PMC7305268 DOI: 10.1007/s11524-020-00435-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Methamphetamine use, sexual relationship power (SRP), and partner violence (PV) are associated with increased risk of sexually transmitted infections (STIs) among women. The objective of our study was to examine the association of recent PV and SRP on STIs by partner type among HIV-negative, heterosexual women who use methamphetamine in San Diego, CA. Using baseline survey data from 209 women enrolled in FASTLANE II, an HIV behavioral intervention trial, we conducted logistic regression analyses to examine associations between PV, SRP, and self-reported lifetime STIs (e.g., chlamydia, gonorrhea). Models focused on PV perpetrated within the past 2 months by: (1) spouse, live-in, or steady sexual partners and (2) casual or anonymous sexual partners. Seventy-eight percent of women reported lifetime physical PV and 57% reported lifetime sexual PV. In the past 2 months, 19.6% reported physical and/or sexual violence by a spouse, live-in, or steady sexual partner, and 7.2% reported physical and/or sexual PV by a casual or anonymous partner. Median SRP score was 2.36 (interquartile range: 2.02-2.68). Twenty-six percent of women reported ever being diagnosed with ≥ 1 STI. While recent physical violence and sexual violence were not associated with STI history among women in steady relationships, women who reported recent sexual violence by casual/anonymous partners were approximately 8 times more likely to ever have an STI compared with those with no history of recent PV by casual/anonymous partners (AOR: 7.70; 95% CI: 1.32, 44.84). SRP was not associated with lifetime STIs among women who reported either partner type. Our findings support a relationship between recent sexual violence perpetrated by casual/anonymous partners and women's STI history. Women who use methamphetamine need help in navigating partner violence experiences. Risk reduction interventions to support this marginalized population are needed.
Collapse
|
8
|
He Y, Zhai J, Liu Y. Association of methamphetamine use with depressive symptoms and gender differences in this association: a meta-analysis. JOURNAL OF SUBSTANCE USE 2020. [DOI: 10.1080/14659891.2020.1736659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yiqin He
- School of Education, Education Science Research Center, Tianjin University, Tianjin, China
| | - Jin Zhai
- Department of Social Work, Changzhou University, Changzhou, China
| | - Yangyang Liu
- School of Education, Education Science Research Center, Tianjin University, Tianjin, China
| |
Collapse
|
9
|
Jiwatram-Negrón T, El-Bassel N. Overlapping intimate partner violence and sex trading among high-risk women: Implications for practice. Women Health 2019; 59:672-686. [PMID: 30543494 PMCID: PMC6565517 DOI: 10.1080/03630242.2018.1544967] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
Abstract
Despite research indicating higher than average rates of intimate partner violence (IPV) across groups of vulnerable women, less is known about the prevalence and types of IPV experienced by women who trade sex for money, drugs, shelter or food, a high risk group for poor health and psychosocial outcomes. Using a cross-sectional design and multivariate logistic regression analyses, this study examined the relationship between IPV and sex trading in a convenience sample of 346 HIV-negative, drug-involved women in relationships, recruited during 2005-2010 in New York City. About 41% and 36% of participants reported lifetime and recent IPV, respectively, by their main partner, with significant differences by recent engagement in sex trading (p < 0.01). Results of multivariate analyses indicated that sex trading was associated with recent severe physical or sexual IPV (OR = 3.07, p < 0.01) and that depression, having ever been married, child sexual abuse, and income were associated with IPV (p < 0.05). Women who reported childhood sexual abuse and recent sex trading had a 7.37 higher odds (p < 0.01) for reporting severe physical or sexual IPV compared to those who reported neither. Findings highlight the need to expand screening and interventions among women who trade sex.
Collapse
Affiliation(s)
- Tina Jiwatram-Negrón
- School of Social Work, Arizona State University, 411 N. Central Avenue, Suite 800, Phoenix, AZ 85004, , 602.496.0677
| | - Nabila El-Bassel
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, 8 Floor, New York, NY, USA, , 212.851.2391
| |
Collapse
|
10
|
Hechter RC, Horberg MA, Weisner C, Campbell CI, Contreras R, Chen LH, Yarborough BJH, Lapham GT, Haller IV, Ahmedani BK, Binswanger IA, Kline-Simon AH, Satre DD. Healthcare Effectiveness Data and Information Set (HEDIS) measures of alcohol and drug treatment initiation and engagement among people living with the human immunodeficiency virus (HIV) and patients without an HIV diagnosis. Subst Abus 2019; 40:302-310. [PMID: 30908174 PMCID: PMC6761030 DOI: 10.1080/08897077.2019.1580239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background: Problematic use of alcohol and other drugs (AOD) is highly prevalent among people living with the human immunodeficiency virus (PLWH), and untreated AOD use disorders have particularly detrimental effects on human immunodeficiency virus (HIV) outcomes. The Healthcare Effectiveness Data and Information Set (HEDIS) measures of treatment initiation and engagement are important benchmarks for access to AOD use disorder treatment. To inform improved patient care, we compared HEDIS measures of AOD use disorder treatment initiation and engagement and health care utilization among PLWH and patients without an HIV diagnosis. Methods: Patients with a new AOD use disorder diagnosis documented between October 1, 2014, and August 15, 2015, were identified using electronic health records (EHR) and insurance claims data from 7 health care systems in the United States. Demographic characteristics, clinical diagnoses, and health care utilization data were also obtained. AOD use disorder treatment initiation and engagement rates were calculated using HEDIS measure criteria. Factors associated with treatment initiation and engagement were examined using multivariable logistic regression models. Results: There were 469 PLWH (93% male) and 86,096 patients without an HIV diagnosis (60% male) in the study cohort. AOD use disorder treatment initiation was similar in PLWH and patients without an HIV diagnosis (10% vs. 11%, respectively). Among those who initiated treatment, few engaged in treatment in both groups (9% PLWH vs. 12% patients without an HIV diagnosis). In multivariable analysis, HIV status was not significantly associated with either AOD use disorder treatment initiation or engagement. Conclusions: AOD use disorder treatment initiation and engagement rates were low in both PLWH and patients without an HIV diagnosis. Future studies need to focus on developing strategies to efficiently integrate AOD use disorder treatment with medical care for HIV.
Collapse
Affiliation(s)
- Rulin C Hechter
- Research and Evaluation Department, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Michael A Horberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland, USA
| | - Constance Weisner
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Cynthia I Campbell
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| | - Richard Contreras
- Research and Evaluation Department, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Lie-Hong Chen
- Research and Evaluation Department, Kaiser Permanente Southern California, Pasadena, California, USA
| | | | - Gwen T Lapham
- Health Research Institute, Kaiser Permanente Washington, Seattle, Washington, USA
| | - Irina V Haller
- Essentia Institute of Rural Health, Essentia Health, Duluth, Minnesota, USA
| | - Brian K Ahmedani
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health System, Detroit, Michigan, USA
| | - Ingrid A Binswanger
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, Colorado, USA
| | - Andrea H Kline-Simon
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.,Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, California, USA
| |
Collapse
|
11
|
Urada LA, Smith LR, Yore J, Triplett DP, Hucks-Ortiz C, Raj A. Sex Trade and Health Care Utilization Among People Living with HIV/AIDS. AIDS Behav 2018; 22:2553-2563. [PMID: 29748844 PMCID: PMC6443569 DOI: 10.1007/s10461-018-2131-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
People living with HIV/AIDS (PLWH) are more likely to have a history of trading sex, but little research has examined whether trading sex is associated with lower health care utilization amongst PLWH. This study assesses this association with PLWH (N = 583) recruited and surveyed from seven community sites in six US cities participating in a multi-site community-based HIV test and treat initiative. Participants were 90.6% Black or Latino, 30.4% homeless, and 9.0% (1 in 11) sold sex (past 90 days). Most reported receiving HIV clinical care (63.9%, past 6 months) and HIV case management (68.9%, past year), but 35.7% reported a missed health care appointment (past 3 months). In adjusted regression models, trading sex was associated with a missed health care appointment (OR = 2.44) and receiving psychological assistance (OR = 2.31), past 90 days, but not receipt of HIV care or supportive HIV services. Trading sex may compromise consistent health care utilization among PLWH.
Collapse
Affiliation(s)
- Lianne A Urada
- School of Social Work, San Diego State University, Hepner Hall #119, 5500 Campanile Drive, San Diego, CA, 92182-4119, USA.
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA.
| | - Laramie R Smith
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA
| | - Jennifer Yore
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA
| | - Daniel P Triplett
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA
| | | | - Anita Raj
- Center on Gender Equity and Health, Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, USA
- Department of Education Studies, Division of Social Sciences, University of California San Diego, La Jolla, USA
| |
Collapse
|
12
|
Saw YM, Saw TN, Chan N, Cho SM, Jimba M. Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk? BMC Public Health 2018; 18:209. [PMID: 29390989 PMCID: PMC5796492 DOI: 10.1186/s12889-018-5113-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 01/23/2018] [Indexed: 01/15/2023] Open
Abstract
Background Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar. Methods A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors. Results A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well. Conclusions High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
Collapse
Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Myanma Perfect Research, Yangon, Myanmar.,Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nyein Chan
- Department of Social Research, Defence Services Medical Research Centre, Tatkone Township, Nay Pyi Taw, Myanmar
| | - Su Myat Cho
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
13
|
Hayashi HD, Patterson TL, Semple SJ, Fujimoto K, Stockman JK. Risk Factors for Recent Intimate Partner Violence among Methamphetamine-Using Men and Women. J Psychoactive Drugs 2017; 48:135-45. [PMID: 27163712 DOI: 10.1080/02791072.2016.1170249] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Substance Abuse, Violence, and HIV/AIDS (SAVA) syndemic model describes how the confluence of the three epidemics of substance abuse, violence, and HIV risk work synergistically to create excess burden among populations. We sought to identify risk factors associated with recent intimate partner violence (IPV) victimization among heterosexual methamphetamine (meth)-using men (n = 108) and women (n = 122) enrolled in FASTLANE-II, an HIV behavioral intervention in San Diego, CA. Women and men reported high rates of physical-only (women: 20%; men: 18%) and sexual (women: 25%; men: 23%) IPV. Multinomial regression analysis revealed that individuals who reported lower social support and individuals who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were more likely to report IPV versus no IPV. Women who reported a greater likelihood of engaging in risky sexual behaviors while high on meth were 1.58 times more likely to report physical-only IPV versus no IPV, while men who reported similar behaviors were 1.15 times more likely to report physical-only IPV versus no IPV. Our findings highlight the influence of interpersonal factors on IPV. This research supports further study on gender-specific risk/protective factors and the development of gender-specific interventions targeting the SAVA syndemic among meth users.
Collapse
Affiliation(s)
- Hitomi D Hayashi
- a Pre-Doctoral Fellow, Department of Health Promotion and Behavioral Sciences , University of Texas School of Public Health , Houston , TX , USA
| | - Thomas L Patterson
- b Professor, Department of Psychiatry , University of California-San Diego , San Diego , CA , USA
| | - Shirley J Semple
- b Professor, Department of Psychiatry , University of California-San Diego , San Diego , CA , USA
| | - Kayo Fujimoto
- a Pre-Doctoral Fellow, Department of Health Promotion and Behavioral Sciences , University of Texas School of Public Health , Houston , TX , USA
| | - Jamila K Stockman
- c Division of Global Public Health, Department of Medicine , University of California-San Diego , San Diego , CA , USA
| |
Collapse
|
14
|
Flynn KC, Hoffer LD. Transitioning illicit drug preferences and emerging user identities in Ohio: The proliferation of methamphetamine use among African Americans. J Ethn Subst Abuse 2017; 18:67-88. [PMID: 28678637 DOI: 10.1080/15332640.2017.1325809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Understanding the social dynamics of local methamphetamine markets is critical to improving community health and reducing social costs associated with illicit drug use. We examine a local drug market in Summit County, Ohio, wherein methamphetamine users ascribe themselves different ethnic identities from those long associated with the drug elsewhere in the United States. Qualitative interviews with 52 study participants demonstrate that very poor and homeless White males and females are now using methamphetamine; however, even more surprising is that 31 of the participants identified themselves as poor or homeless, male or female African, Native, biracial, or multiracial Americans. The drug use trajectory of these 31 participants in particular involved a transition from a historical preference for crack to a present one for methamphetamine and, in some cases, a preference for concurrent use of methamphetamine and heroin. Many of these methamphetamine users also emphasized their ethnic identity to distinguish themselves as nonproducers of methamphetamine in comparison to Whites, who are commonly associated with methamphetamine production. Findings appear to suggest an emergent means of identity management resulting from the ethnic diversity of users in this methamphetamine market. These findings may have relevance in other communities with similar demographics and drug markets and may hold important implications for drug treatment, policy-making, and law enforcement professionals' work associated with methamphetamine users, producers, and distributors.
Collapse
Affiliation(s)
| | - Lee D Hoffer
- a Case Western Reserve University , Cleveland , Ohio
| |
Collapse
|
15
|
Lion RR, Watt MH, Wechsberg WM, Meade CS. Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa. Subst Use Misuse 2017; 52:773-784. [PMID: 28379107 PMCID: PMC5600888 DOI: 10.1080/10826084.2016.1264964] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence. OBJECTIVES This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa. METHODS Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women. RESULTS In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior.
Collapse
Affiliation(s)
- Ryan R Lion
- a Duke Global Health Institute, Duke University , Durham , North Carolina , USA
| | - Melissa H Watt
- b Department of Psychiatry & Behavioral Science , Duke University School of Medicine , Durham , North Carolina , USA
| | - Wendee M Wechsberg
- c Substance Abuse Treatment Evaluations and Interventions, RTI International , Research Triangle Park , North Carolina , USA
| | - Christina S Meade
- a Duke Global Health Institute, Duke University , Durham , North Carolina , USA
- b Department of Psychiatry & Behavioral Science , Duke University School of Medicine , Durham , North Carolina , USA
| |
Collapse
|
16
|
Saw YM, Saw TN, Wai KM, Poudel KC, Win HH. Correlates of sex trading among male non-injecting drug users in Myanmar: a cross-sectional study. Harm Reduct J 2016; 13:34. [PMID: 27919289 PMCID: PMC5139087 DOI: 10.1186/s12954-016-0123-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 11/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sex trading is a recognized risk factor for human immune deficiency virus infection and other sexually transmitted infections among non-injecting drug users (NIDUs). However, very little research has addressed the factors associated with sex trading among male NIDUs in Myanmar. METHODS A cross-sectional study was conducted from January to February 2010 using the respondent-driven sampling method. In total, 210 NIDUs aged between 18 and 49 years, with no history of injecting drug use, and who used non-injected illicit drugs in the last 6 months were recruited. Face-to-face interviews were conducted using a structured questionnaire to collect information on participants' sexual and drug use behaviors. Binary and multivariate logistic regressions were applied to analyze the resulting data. RESULTS Of 210 NIDUs, 84 (40%) reported involvement in the sex trade during the last 3 months. In the adjusted model, factors associated with sex trade involvement included homosexual preference (adjusted odds ratio [AOR] 4.90; 95% confidence interval [CI] 1.61-14.95), having more than two partners (AOR = 3.88; 95% CI 1.55-9.72), had a regular job (AOR = 5.10; 95% CI 1.65-15.72), use of stimulant drugs rather than opiate (AOR = 2.38; 95% CI 1.10-5.15), and who used drugs more than twice per day. CONCLUSIONS More than one third of NIDUs were involved in sex trading. This study suggested that further comprehensive intervention programs that aim to reduce risk factors of trading sex among NIDUs may consider including NIDUs who used stimulant drugs, had regular/full-time jobs, used drugs more than twice per day, and had homosexual preferences.
Collapse
Affiliation(s)
- Yu Mon Saw
- Department of Healthcare Administration, Graduate School of Medicine, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. .,Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
| | - Thu Nandar Saw
- Myanma Perfect Research, Yangon, Myanmar.,Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kyi Mar Wai
- Department of Human Ecology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Krishna C Poudel
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Hla Hla Win
- Department of Preventive and Social Medicine, University of Medicine 1, Yangon, Myanmar
| |
Collapse
|
17
|
Feaster DJ, Parish CL, Gooden L, Matheson T, Castellon PC, Duan R, Pan Y, Haynes LF, Schackman BR, Malotte CK, Mandler RN, Colfax GN, Metsch LR. Substance use and STI acquisition: Secondary analysis from the AWARE study. Drug Alcohol Depend 2016; 169:171-179. [PMID: 27837708 PMCID: PMC5140686 DOI: 10.1016/j.drugalcdep.2016.10.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 10/17/2016] [Accepted: 10/23/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Sexually transmitted infections (STIs) are significant public health and financial burdens in the United States. This manuscript examines the relationship between substance use and prevalent and incident STIs in HIV-negative adult patients at STI clinics. METHODS A secondary analysis of Project AWARE was performed based on 5012 patients from 9 STI clinics. STIs were assessed by laboratory assay and substance use by self-report. Patterns of substance use were assessed using latent class analysis. The relationship of latent class to STI rates was investigated using Poisson regression by population groups at high risk for STIs defined by participant's and partner's gender. RESULTS Drug use patterns differed by risk group and substance use was related to STI rates with the relationships varying by risk behavior group. Substance use treatment participation was associated with increased STI rates. CONCLUSIONS Substance use focused interventions may be useful in STI clinics to reduce morbidity associated with substance use. Conversely, gender-specific sexual health interventions may be useful in substance use treatment.
Collapse
Affiliation(s)
- Daniel J Feaster
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Carrigan L Parish
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Lauren Gooden
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Tim Matheson
- San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, San Francisco, CA 94102, USA.
| | - Pedro C Castellon
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, Miami Research Center, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Rui Duan
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Yue Pan
- University of Miami Miller School of Medicine, Department of Public Health Sciences, 1120 NW 14th St., Miami, FL 33136, USA.
| | - Louise F Haynes
- Medical University of South Carolina, Addiction Sciences Division, 67 President Street, Charleston, SC 29425, USA.
| | - Bruce R Schackman
- Weill Cornell Medical College, Department of Healthcare Policy and Research, 425 East 61st St., New York, NY, USA.
| | - C Kevin Malotte
- California State University, Long Beach, Department of Health Sciences, Center for Health Care Innovation, 5500 Atherton St., Long Beach, CA, USA.
| | - Raul N Mandler
- National Institute of Health, National Institute on Drug Abuse, 6000 Executive Boulevard, Rockville, MD 20852, USA.
| | - Grant N Colfax
- San Francisco Department of Public Health, HIV Prevention Section, 25 Van Ness Avenue, San Francisco, CA 94102, USA.
| | - Lisa R Metsch
- Columbia University Mailman School of Public Health, Department of Sociomedical Sciences, 722 W 168th St., 9th Floor, New York, NY 10032, USA.
| |
Collapse
|
18
|
Clingan SE, Fisher DG, Pedersen WC, Reynolds GL, Xandre P. Impulsiveness, and trait displaced aggression among drug using female sex traders. Addict Behav 2016; 60:24-31. [PMID: 27082265 DOI: 10.1016/j.addbeh.2016.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 02/09/2016] [Accepted: 03/29/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This study compared women who sex trade for drugs, money, or both compared to neither (did not sex trade), and introduced the concept of trait displaced aggression to the literature on sex trading. METHODS Female participants (n=1055) were recruited from a low-income area of southern California. Measures included: the Risk Behavior Assessment (RBA), Barratt Impulsivity Scale (BIS), Eysenck Impulsiveness Scale (EIS), and the Displaced Aggression Questionnaire (DAQ). RESULTS Women who traded sex for both drugs and money used crack cocaine, powder cocaine, and alcohol significantly more, scored higher on the BIS, and the EIS, and were significantly older. Those who only sex traded for drugs used more amphetamine, heroin, and injected drugs more days. They were also higher on the DAQ and all of the DAQ subscales. Those who traded for money only used marijuana more and were more likely to use marijuana before sex. CONCLUSIONS This study may help address specific issues unique to those who sex trade for different commodities in that the drugs used are different and the underlying personality characteristics are different.
Collapse
Affiliation(s)
- Sarah E Clingan
- Psychology Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA
| | - Dennis G Fisher
- Psychology Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA.
| | - William C Pedersen
- Psychology Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA
| | - Grace L Reynolds
- Health Care Administration Department, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA
| | - Pamela Xandre
- School of Nursing, California State University, Long Beach, 1250 Bellflower Boulevard, Long Beach, CA 90840, USA
| |
Collapse
|
19
|
Watt MH, Kimani SM, Skinner D, Meade CS. "Nothing Is Free": A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:923-933. [PMID: 25567071 PMCID: PMC4496309 DOI: 10.1007/s10508-014-0418-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/22/2014] [Accepted: 10/06/2014] [Indexed: 06/04/2023]
Abstract
South Africa is facing an established epidemic of methamphetamine, known locally as "tik." Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention.
Collapse
Affiliation(s)
- Melissa H Watt
- Duke Global Health Institute, Duke University, Duke Box 90519, Durham, NC, 27708, USA.
| | - Stephen M Kimani
- Duke Global Health Institute, Duke University, Duke Box 90519, Durham, NC, 27708, USA
| | - Donald Skinner
- Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Christina S Meade
- Duke Global Health Institute, Duke University, Duke Box 90519, Durham, NC, 27708, USA
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
20
|
Occupational and demographic factors associated with drug use among female sex workers at the China-Myanmar border. Drug Alcohol Depend 2016; 161:42-9. [PMID: 26897586 DOI: 10.1016/j.drugalcdep.2016.01.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND Within the last decade, the use of amphetamine type stimulants (ATS) has swelled in Myanmar. Regionally, female sex workers have reported turning to ATS for occupational reasons. In doing so, drug-using female sex workers (FSW) face compounded risks for HIV and other sexually transmitted infections (STI). Here, we examine the factors that impact FSW drug use in Muse, a town along the China-Myanmar border. METHODS In 2012, 101 FSW were recruited from entertainment venues and brothels along the Myanmar-Chinese border. Participants participated in a self-administered behavioral survey covering demographics, drug use, sex work, and risk behaviors. Bivariate and regression analyses were conducted in SPSS. RESULTS Thirty four percent of respondents indicated current drug use. ATS derivatives were the most commonly used drugs (87.5%) with injection drug use being nearly non-existent in the sample. Drug using FSWs were older, had engaged in sex work longer, had more Chinese clients, and were more likely to have a previous boyfriend who had used drugs. They were also 3.5 times more likely to report a STI. Client condom use, HIV testing rates, and familiarity with public health resources did not statistically differ by drug use status. CONCLUSION More research is needed to examine how romantic and professional sexual relationships push-and-pull FSW into using drugs. Our results suggest that diverse safer sex strategies, beyond client condom use, should be promoted with drug using FSWs, including strategies that acknowledge the impact of ATS use.
Collapse
|
21
|
Mialon HM, Nesson ET, Samuel MC. Crystal Clear? The Relationship Between Methamphetamine Use and Sexually Transmitted Infections. HEALTH ECONOMICS 2016; 25:292-313. [PMID: 25545965 DOI: 10.1002/hec.3140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 09/04/2014] [Accepted: 11/24/2014] [Indexed: 06/04/2023]
Abstract
Public health officials have cited methamphetamine control as a tool with which to decrease HIV and other sexually transmitted infections, based on previous research that finds a strong positive correlation between methamphetamine use and risky sexual behavior. However, the observed correlation may not be causal, as both methamphetamine use and risky sexual behavior could be driven by a third factor, such as a preference for risky behavior. We estimate the effect of methamphetamine use on risky sexual behavior using monthly data on syphilis diagnoses in California and quarterly data on syphilis, gonorrhea, and chlamydia diagnoses across all states. To circumvent possible endogeneity, we use a large exogenous supply shock in the US methamphetamine market that occurred in May 1995 and a later shock stemming from the Methamphetamine Control Act, which went into effect in October 1997. While the supply shocks had large negative effects on methamphetamine use, we find no evidence that they decreased syphilis, gonorrhea, or chlamydia rates. Our results have broad implications for public policies designed to decrease sexually transmitted infection rates.
Collapse
Affiliation(s)
- Hugo M Mialon
- Department of Economics, Emory University, Atlanta, GA, USA
| | - Erik T Nesson
- Department of Economics, Ball State University, Muncie, IN, USA
| | - Michael C Samuel
- Surveillance and Epidemiology Section, STD Control Branch, California Department of Public Health, Richmond, CA, USA
| |
Collapse
|
22
|
Salina DD, Ram D, Jason LA. Perceptions of women's HIV risk and partner HIV risk behaviors in substance using women with criminal justice involvement. ACTA ACUST UNITED AC 2015; 1:33-39. [PMID: 28845300 PMCID: PMC5568646 DOI: 10.15761/cbhc.1000109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
This article explores the perceptions of STI/HIV risk based on engagement in risk behaviors in a sample of women with substance use disorders and criminal justice involvement. We examined variables associated with higher risk of contracting STI/HIV: having more than one current sex partner, injecting drugs, and trading sex. We also examined risk variables associated with intimate relationships: whether a partner had ever been in prison, injected drugs, or shared needles. Findings reveal that certain high-risk behaviors influenced participant perceptions of HIV risk: having more than one current sex partner, having a partner who injected drugs, having a partner who had sex with a man, or having a partner who had been tested for HIV. Participants who were uncertain about whether a partner had engaged in risk behaviors had significantly higher worry and perceptions of HIV risk than participants who were certain of partners’ risk behaviors. The implications of these findings for tailoring effective interventions for high-risk women are addressed.
Collapse
Affiliation(s)
| | - Daphna Ram
- Center for Community Research, DePaul University, Chicago, IL, USA
| | - Leonard A Jason
- Center for Community Research, DePaul University, Chicago, IL, USA
| |
Collapse
|
23
|
Schonbrun YC, Johnson J, Anderson BJ, Stein MD. Sex Trading Among Hazardously Drinking Jailed Women. WOMEN & CRIMINAL JUSTICE 2015; 26:165-179. [PMID: 28190917 PMCID: PMC5300066 DOI: 10.1080/08974454.2015.1083931] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
For women involved in sex trading, both alcohol problems and passage through the criminal justice system are highly prevalent. This study is the first to conduct a focused examination of factors associated with sex trading among hazardously drinking, pretrial, jailed women. Cocaine use, social support for alcohol abstinence, and more days incarcerated in the 90 days leading up to the index incarceration were significantly associated with sex trading involvement among alcoholic women. Helping incarcerated alcoholic women reduce cocaine use and improve sober support networks during and following an incarceration may minimize sex trading after release.
Collapse
|
24
|
Jiwatram-Negrón T, El-Bassel N. Correlates of Sex Trading among Drug-Involved Women in Committed Intimate Relationships: A Risk Profile. Womens Health Issues 2015; 25:420-8. [PMID: 26092746 DOI: 10.1016/j.whi.2015.04.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Despite a slight decline in new human immunodeficiency virus (HIV) infections in New York, marked increases and concentrated epidemics continue among subsets of the population, including women engaged in sex trading. We examined the prevalence and correlates of sex trading among 346 low-income, HIV-negative women in HIV-concordant intimate relationships. METHODS Women and their long-term main partners were recruited to participate in an HIV prevention intervention. Baseline data were used in this article. FINDINGS Of the 346 women in the study, 28% reported sex trading during the prior 90 days. Multivariate analyses showed increased relative risk of sex trading by lifetime experience of severe intimate partner violence (IPV), drug, and alcohol use, and marginal significance for mental health hospitalization, partner drug dependency, and homelessness. CONCLUSIONS These findings suggest an urgent need for HIV prevention and intervention efforts targeted toward women in intimate relationships who trade sex for money or drugs, with an emphasis on IPV, mental health, history of incarceration, and substance abuse.
Collapse
Affiliation(s)
- Tina Jiwatram-Negrón
- Social Intervention Group (SIG), School of Social Work, Columbia University, New York City, New York.
| | - Nabila El-Bassel
- Social Intervention Group (SIG), School of Social Work, Columbia University, New York City, New York
| |
Collapse
|
25
|
Maxwell JC. A new survey of methamphetamine users in treatment: who they are, why they like "meth," and why they need additional services. Subst Use Misuse 2014; 49:639-44. [PMID: 24093526 DOI: 10.3109/10826084.2013.841244] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The quality and quantity of illicit methamphetamine has recently increased due to introduction of a new precursor, 1-phenyl-2-propanone (P2P). This paper updates the problems associated with methamphetamine use. Methamphetamine-using clients (N = 222) entering a Texas program participated in computer-assisted interviews in 2010 and 2011 about routes of administration, other drugs used, severity of dependence, mental and physical health, perceived risks and benefits of use, family history, and abuse and neglect experienced as children and adults. Special needs of this population include therapies for trauma, gender-focused counseling, safe housing, and prevention messages to discourage use of the drug.
Collapse
Affiliation(s)
- Jane Carlisle Maxwell
- Center for Social Work Research, University of Texas at Austin , Austin, Texas , USA
| |
Collapse
|
26
|
Coffin PO, Santos GM, Das M, Santos DM, Huffaker S, Matheson T, Gasper J, Vittinghoff E, Colfax GN. Aripiprazole for the treatment of methamphetamine dependence: a randomized, double-blind, placebo-controlled trial. Addiction 2013. [PMID: 23186131 PMCID: PMC3602333 DOI: 10.1111/add.12073] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To test aripiprazole for efficacy in decreasing use in methamphetamine-dependent adults, compared to placebo. DESIGN Participants were randomized to receive 12 weeks of aripiprazole or placebo, with a 3-month follow-up and a platform of weekly 30-minute substance abuse counseling. SETTING The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health. PARTICIPANTS Ninety actively using, methamphetamine-dependent, sexually active adults were recruited from community venues. MEASUREMENTS The primary outcome was regression estimated reductions in weekly methamphetamine-positive urines. Secondary outcomes were study medication adherence [by self-report and medication event monitoring systems (MEMS)], sexual risk behavior and abstinence from methamphetamine. FINDINGS Participant mean age was 38.7 years, 87.8% were male, 50.0% white, 18.9% African American, and 16.7% Latino. Eighty-three per cent of follow-up visits and final visits were completed. By intent-to-treat, participants assigned to aripiprazole had similar reductions in methamphetamine-positive urines as participants assigned to placebo [risk ratio (RR) 0.88, 95% confidence interval (CI): 0.66-1.19, P = 0.41]. Urine positivity declined from 73% (33 of 45 participants) to 45% (18 of 40) in the placebo arm and from 77% (34 of 44) to 44% (20 of 35) in the aripiprazole arm. Adherence by MEMS and self-report was 42 and 74%, respectively, with no significant difference between arms (MEMS P = 0.31; self-report P = 0.17). Most sexual risk behaviors declined similarly among participants in both arms (all P > 0.05). There were no serious adverse events related to study drug, although participants randomized to aripiprazole reported more akathisia, fatigue and drowsiness (P < 0.05). CONCLUSION Compared with placebo, aripiprazole did not reduce methamphetamine use significantly among actively using, dependent adults.
Collapse
Affiliation(s)
- PO Coffin
- San Francisco Department of Public Health,University of California, San Francisco
| | - GM Santos
- San Francisco Department of Public Health,University of California, San Francisco
| | - M Das
- San Francisco Department of Public Health,University of California, San Francisco
| | - DM Santos
- San Francisco Department of Public Health
| | - S Huffaker
- San Francisco Department of Public Health
| | - T Matheson
- San Francisco Department of Public Health
| | - J Gasper
- San Francisco Department of Public Health
| | | | - GN Colfax
- San Francisco Department of Public Health,University of California, San Francisco
| |
Collapse
|
27
|
Urada LA, Strathdee SA, Morisky DE, Schilling RF, Simbulan NP, Estacio LR, Raj A. Sex work and its associations with alcohol and methamphetamine use among female bar and spa workers in the Philippines. Asia Pac J Public Health 2013; 26:138-46. [PMID: 23343641 DOI: 10.1177/1010539512471969] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To assess the prevalence of sex work and its associations with substance use among female bar/spa workers in the Philippines (N = 498), workers from 54 bar or spa venues in Metro Manila (2009-2010) were surveyed on demographics, drug/alcohol use, abuse history, and sex work. Their median age was 23 years and 35% engaged in sex work. Sex work was independently associated with methamphetamine use (19% vs 4%; adjusted odds ratio [AOR] =2.9, 95% confidence interval [CI] = 1.3-6.2), alcohol use with patrons (49% vs. 27%; AOR = 1.9, 95% CI = 1.1-3.4), and alcohol intoxication during sex (50% vs. 24%; AOR = 2.0, 95% CI = 1.2-3.5), but inversely associated with daily alcohol use (13% vs. 16%; AOR = 0.2, 95% CI = 0.1-0.5). Additional significant covariates included sexual abuse history, younger age, and not having a higher education. Findings suggest that interventions with sex workers in bars and spas should focus on methamphetamine use, alcohol use contexts, and violence victimization, to better meet the needs of this population.
Collapse
Affiliation(s)
- Lianne A Urada
- 1University of California, San Diego, School of Medicine, La Jolla, CA, USA
| | | | | | | | | | | | | |
Collapse
|
28
|
Dual HIV risk and vulnerabilities among women who use or inject drugs: no single prevention strategy is the answer. Curr Opin HIV AIDS 2012; 7:326-31. [PMID: 22498480 DOI: 10.1097/coh.0b013e3283536ab2] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW This article examines the dual HIV and sexually transmitted infection (STI) risk behaviors engaged in by women who use or inject drugs; the individual, social, and structural drivers of HIV and STI risk; prevention strategies; and the implications for multilevel, combined, sex-specific HIV prevention strategies. RECENT FINDINGS Women who use or inject drugs, especially female sex workers, are at dual risk for HIV, the hepatitic C virus (HCV), and other STIs. In countries with HIV prevalence higher than 20% among injecting drug users (IDUs), female IDUs have slightly higher HIV prevalence than male IDUs. Women who use or inject drugs face multilevel drivers that increase their vulnerabilities to HIV, HCV, and STIs. Despite advances in behavioral HIV prevention strategies for this population, most prevention studies have not sufficiently targeted dyadic, social, and structural levels. Few recent advances in biomedical HIV prevention have focused on women who use drugs and their unique needs. SUMMARY HIV prevention strategies and services need to address the unique and multilevel drivers that increase the vulnerabilities to HIV, HCV, and STIs among women who use drugs including those who engage in sex work. Scaling-up and improving access to multilevel and combined HIV prevention strategies for these women is central to combating the HIV epidemic.
Collapse
|
29
|
Abstract
PURPOSE OF REVIEW To evaluate the incidence of club drug use in pediatric patients, especially those aged 13-25, and how it relates to the spread of HIV. RECENT FINDINGS Transmission of HIV among younger patients has become largely associated with risky sexual behaviors, as the rate of transmission from vertical infection and intravenous drug use has decreased. Use of club drugs in emerging adult populations contributes to the HIV epidemic through a combination of decreased inhibitions as well as physiological effects that increase high-risk sexual practices. Robust data exists linking the use of club drugs by the men who have sex with men population with spread of HIV, but this data in other at-risk populations (e.g. African Americans) is not as robust. Additional research is needed to identify the rates of transmission among adolescents and emerging adults, as well as knowledge, attitudes, beliefs, and practices that affect HIV transmission in this population. SUMMARY Use of club drugs by adolescents and emerging adults contributes to the current rate of HIV transmission among this age group.
Collapse
Affiliation(s)
- Matthew D Zuckerman
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
| | | |
Collapse
|