Abstract

A global examination violence in the lives of female injection drug users

Presented by Anna Roberts (Australia).

A. Roberts, B. Mathers, L. Degenhardt

National Drug and Alcohol Research Centre, University of New South Wales, Medicine, Sydney, Australia

Background: The lives of many female injection drug users (IDU) are marked with physical, sexual and/or emotional violence. IDU, particularly female IDU, report higher levels of violence than the general population. This violence can continue throughout their lives and impact drug use, relationships and treatment seeking. The majority of research on this topic has been carried out in developed country settings leaving a substantial gap in knowledge around the situation of female IDU in the developing world.
Methods: A comprehensive global review of peer-reviewed and grey literature was undertaken on behalf of the Reference Group to the UN on HIV and Injecting Drug Use with a particular focus on the developing world to explore the role of violence in the lives of female IDU and how it impacts their injection and sexual HIV risk behaviours.
Results: Both male and female IDUs are exposed to violence/exploitation associated with drug acquisition but female IDUs face greater levels of violence from their immediate social circle, a risk factor for risky sexual and injection behaviours. Female IDU are more likely than male IDU to have an IDU partner. Intimate partner violence (IPV)is significantly higher in IDU relationships than in the general population and is associated with women participating in risky sexual behaviours both in and out of the relationship. Female IDUs engaged in sex work (SW) are exposed further to violence associated with street level SW from clients, police and the street environment. Female IDU have also reported violence when seeking treatment from partners and/or from male treatment seekers, which may lessen motivation to attend.
Conclusions: These risks necessitate that harm minimization and drug treatment programs for women include psychological services to deal with long term and varying violence, while programs for men should include services around anger management, domestic abuse counselling, and partner support programs.