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Changing our outlook towards vulnerable women for societal resilience

  • Nitish Sookool and Marie Chan Sun ORCID logo EMAIL logo
Published/Copyright: May 4, 2023
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Abstract

Background: The vulnerabilities and risks of women injecting drug users (WIDUs) are different compared to their male counterparts. In light of scant literature in this area, we carried out this qualitative study with the aim to explore the lived experiences of WIDUs in the North of Mauritius. Its objectives were (1) To get an insight into the risks taken during the injection practices of WIDUs and (2) To obtain an in-depth understanding of the gender-specific vulnerability of the sexual behaviours of WIDUs. Methods: A qualitative phenomenological approach was used for the research work. Study participants were recruited from a specific needle exchange site, by purposive sampling until saturation of data was reached. In-depth interviews conducted were transcribed for thematic analysis. Ethical clearance was obtained from the relevant authorities. Findings: The principal theme which emerged from the data collected was “Drug Injection Scenario”, with the following sub-themes: settings for drug injection; pre-injection rituals; third party assistance; sharing and recycling of injecting materials. The second theme which came out was “Sex Work and Drug Use Interplay” with either sex work preceding drug injection or drug injection preceding sex work. Finally, the third theme was “Sexual Behaviours Screenplay” with casual encounters and unprotected sex. Conclusions: This study filled the gap with respect to the absence of qualitative studies among WIDUs in Mauritius. It revealed their risky drug injecting practices and sexual behaviours. Their psychological and physical dependence on drug injection contributed to their stay within this vulnerable circle. Their inability to access adequate support hinders them from coming out of the clutches of their risky drug injection and sexual practices. For resilience of the society, there is need to address the needs of this vulnerable group of women.


Corresponding author: Marie Chan Sun, Department of Medicine, Faculty of Medicine and Health Sciences, University of Mauritius , Réduit, 80837, Mauritius, E-mail:

Acknowledgments

Mrs Anne Marie Cupidon Guilliani, at “Collectif Urgence Toxida ”, Non-Governmental Organisation for granting permission to have access to WIDUS. Mrs Winda Moutou, at the Needle Exchange Site for arranging appointments with WIDUs. We are grateful to all the women who participated in this research work.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: The authors declare that they have received no funding for this research work.

  3. Conflict of interest statement: The authors declare no conflicts of interest regarding this article.

  4. Ethical approval: Obtained from the University of Mauritius relevant ethics committee.

References

1. Chelin, R. Drug trafficking/synthetic drugs on the rise despite Mauritius’s best efforts. ENACT project, Institute of Security Studies; 2020. Available from: https://enactafrica.org/enact-observer/synthetic-drugs-on-the-rise-despite-mauritiuss-best-efforts.Search in Google Scholar

2. United Nations. World drug report; 2010. Available from: https://www.unodc.org/unodc/en/data-and-analysis/WDR-2010.html [Accessed 28 Oct 2022].Search in Google Scholar

3. Ministry of Health and Quality of Life. Integrated biological and behavioural surveillance: a respondent driven survey among PWIDS in the Island of Mauritius. Port Louis: Government Printing Press; 2007.Search in Google Scholar

4. United Nations. Women and drug use: the problem in India. New Delhi: United Nations Office of Drugs Crime; 2002.Search in Google Scholar

5. United Nations. World drug report; 2022. Available from: https://www.unodc.org/res/wdr2022/MS/WDR22_Special_Points.pdf [Accessed 28 Oct 2022].Search in Google Scholar

6. Tweed, EJ, Miller, RG, Schofield, J, Barnsdale, L, Matheson, C. Why are drug-related deaths among women increasing in Scotland? A mixed-methods analysis of possible explanations. Drugs Educ Prev Pol 2022;29:62–75. https://doi.org/10.1080/09687637.2020.1856786.Search in Google Scholar PubMed PubMed Central

7. Collins, LH. Alcohol and drug addiction in women: phenomenology and prevention. In: Ballou, M, Brown, LS, editors. Rethinking mental health and disorder: feminist perspectives. New York: The Guilford Press; 2002: 198–230 pp.Search in Google Scholar

8. Tuchman, E. Women and addiction: the importance of gender issues in substance abuse research. J Addict Dis 2010;29:127–38. https://doi.org/10.1176/foc.9.1.foce90.Search in Google Scholar

9. Tuchman, E. Women’s injection drug practices in their own words: a qualitative study. Harm Reduct J 2015;12:1–8. https://doi.org/10.1186/s12954-015-0041-6.Search in Google Scholar PubMed PubMed Central

10. Johnston, L, Saumtally, A, Corceal, S, Mahadoo, I, Oodally, F. High HIV and hepatitis C prevalence amongst injecting drug users in Mauritius: findings from a population size estimation and respondent driven sampling survey. Int J Drug Pol 2011;22:252–8. https://doi.org/10.1016/j.drugpo.2011.05.007.Search in Google Scholar PubMed

11. Kermode, M, Longleng, V, Singh, BC, Bowen, K, Rintoul, A. Killing time with enjoyment: a qualitative study of initiation into injecting drug use in north-east India. Subst Use Misuse 2009;44:1070–89. https://doi.org/10.1080/10826080802486301.Search in Google Scholar PubMed

12. Neaigus, A, Gyarmathy, VA, Miller, M, Frajzyngier, VM, Friedman, SR, Des Jarlais, DC. Transitions to injecting drug use among noninjecting heroin users: social network influence and individual susceptibility. J Acquir Immune Defic Syndr 2006;41:493–503. https://doi.org/10.1097/01.qai.0000186391.49205.3b.Search in Google Scholar PubMed

13. Fuller, CM, Borrell, LN, Latkin, CA, Galea, S, Ompad, DC, Strathdee, SA, et al.. Effects of race, neighborhood, and social network on age at initiation of injection drug use. Am J Publ Health 2005;95:689–95. https://doi.org/10.2105/ajph.2003.02178.Search in Google Scholar PubMed PubMed Central

14. Hien, DA, Nunes, E, Levin, FR, Fraser, D. Posttraumatic stress disorder and short-term outcome in early methadone treatment. J Subst Abuse Treat 2000;19:31–7. https://doi.org/10.1016/s0740-5472(99)00088-4.Search in Google Scholar PubMed

15. Bryant, J, Treloar, C. The gendered context of initiation to injecting drug use: evidence for women as active initiates. Drug Alcohol Rev 2007;26:287–93. https://doi.org/10.1080/09595230701247731.Search in Google Scholar PubMed

16. Roy, E, Haley, N, Leclerc, P, Cédras, L, Boivin, JF. Drug injection among street youth: the first time. Addiction 2002;97:1003–9. https://doi.org/10.1046/j.1360-0443.2002.00161.x.Search in Google Scholar PubMed

17. Vidal-Trecan, GM, Varescon-Pousson, I, Boissonnas, A. Injection risk behaviors at the first and at the most recent injections among drug users. Drug Alcohol Depend 2002;66:107–9. https://doi.org/10.1016/s0376-8716(01)00196-x.Search in Google Scholar PubMed

18. Crofts, N, Louie, R, Rosenthal, D, Jolley, D. The first hit: circumstances surrounding initiation into injecting. Addiction 1996;91:1187–96. https://doi.org/10.1046/j.1360-0443.1996.918118710.x.Search in Google Scholar PubMed

19. Doherty, MC, Garfein, RS, Monterroso, E, Latkin, C, Vlahov, D. Gender differences in the initiation of injection drug use among young adults. J Urban Health 2000;77:396–414. https://doi.org/10.1007/bf02386749.Search in Google Scholar PubMed PubMed Central

20. Diaz, T, Vlahov, D, Edwards, V, Conover, S, Monterroso, E. Sex-specific differences in circumstances of initiation into injecting-drug use among young adult Latinos in Harlem, New York City. AIDS Behav 2002;6:117–22. https://doi.org/10.1023/a:1015441030030.10.1023/A:1015441030030Search in Google Scholar

21. Strathdee, SA, Philbin, MM, Semple, SJ, Pu, M, Orozovich, P, Martinez, G, et al.. Correlates of injection drug use among female sex workers in two Mexico–US border cities. Drug Alcohol Depend 2008;92:132–40. https://doi.org/10.1016/j.drugalcdep.2007.07.001.Search in Google Scholar PubMed PubMed Central

22. MacRae, R, Aalto, E. Gendered power dynamics and HIV risk in drug‐using sexual relationships. AIDS Care 2000;12:505–15. https://doi.org/10.1080/09540120050123909.Search in Google Scholar PubMed

23. Absalon, J, Fuller, CM, Ompad, DC, Blaney, S, Koblin, B, Galea, S, et al.. Gender differences in sexual behaviors, sexual partnerships, and HIV among drug users in New York City. AIDS Behav 2006;10:707–15. https://doi.org/10.1007/s10461-006-9082-x.Search in Google Scholar PubMed

24. Shah, NG, Galai, N, Celentano, DD, Vlahov, D, Strathdee, SA. Longitudinal predictors of injection cessation and subsequent relapse among a cohort of injection drug users in Baltimore, MD, 1988–2000. Drug Alcohol Depend 2006;83:147–56. https://doi.org/10.1016/j.drugalcdep.2005.11.007.Search in Google Scholar PubMed

25. Mburu, G, Limmer, M, Holland, P. Role of boyfriends and intimate sexual partners in the initiation and maintenance of injecting drug use among women in coastal Kenya. Addict Behav 2019;93:20–8. https://doi.org/10.1016/j.addbeh.2019.01.013.Search in Google Scholar PubMed

26. Hearn, KD, O’Sullivan, LF, El-Bassel, N, Gilbert, L. Intimate partner violence and monogamy among women in methadone treatment. AIDS Behav 2005;9:177–86. https://doi.org/10.1007/s10461-005-3899-6.Search in Google Scholar PubMed

27. Loxley, W, Ovenden, C. Friends and lovers: needle sharing in young people in Western Australia. AIDS Care 1995;7:337–52. https://doi.org/10.1080/09540129550126551.Search in Google Scholar PubMed

28. Burns, K. Women, harm reduction, and HIV: key findings from Azerbaijan, Georgia, Kyrgyzstan, Russia, and Ukraine. Open Society Institute; 2009. Available from: https://idpc.net/publications/2009/11/osi-report-women-harm-reduction-hiv.Search in Google Scholar

29. Bruneau, J, Lamothe, F, Franco, E, Lachance, N, Désy, M, Soto, J, et al.. High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: results of a cohort study. Am J Epidemiol 1997;146:994–1002. https://doi.org/10.1093/oxfordjournals.aje.a009240.Search in Google Scholar PubMed

30. Harcourt, C, van Beek, I, Heslop, J, McMahon, M, Donovan, B. The health and welfare needs of female and transgender street sex workers in New South Wales. Aust N Z J Publ Health 2001;25:84–9. https://doi.org/10.1111/j.1467-842x.2001.tb00556.x.Search in Google Scholar PubMed

31. Benotsch, EG, Somlai, AM, Pinkerton, SD, Kelly, JA, Ostrovski, D, Gore-Felton, C, et al.. Drug use and sexual risk behaviours among female Russian IDUs who exchange sex for money or drugs. Int J STD AIDS 2004;15:343–7. https://doi.org/10.1177/095646240401500514.Search in Google Scholar PubMed

32. Smith, FM, Marshall, LA. Barriers to effective drug addiction treatment for women involved in street‐level prostitution: a qualitative investigation. Crim Behav Ment Health 2007;17:163–70. https://doi.org/10.1002/cbm.654.Search in Google Scholar PubMed

33. Fuller, CM, Vlahov, D, Latkin, CA, Ompad, DC, Celentano, DD, Strathdee, SA. Social circumstances of initiation of injection drug use and early shooting gallery attendance: implications for HIV intervention among adolescent and young adult injection drug users. J Acquir Immune Defic Syndr 2003;32:86–93. https://doi.org/10.1097/00126334-200301010-00013.Search in Google Scholar PubMed

34. Estebanez, PE, Russell, NK, Aguilar, MD, Béland, F, Zunzunegui, MV. Women, drugs and HIV/AIDS: results of a multicentre European study. Int J Epidemiol 2000;29:734–43. https://doi.org/10.1093/ije/29.4.734.Search in Google Scholar PubMed

35. Semaan, S, Des Jarlais, DC, Sogolow, E, Johnson, WD, Hedges, LV, Ramirez, G, et al.. A meta-analysis of the effect of HIV prevention interventions on the sex behaviors of drug users in the United States. In: Database of Abstracts of Reviews of Effects (DARE): quality-assessed reviews [Internet], Centre for Reviews and Dissemination, UK. Alphen aan den Rijn, the Netherlands: Wolters Kluwer Health, Inc; 2002.Search in Google Scholar

Received: 2022-11-06
Accepted: 2023-04-04
Published Online: 2023-05-04

© 2023 Walter de Gruyter GmbH, Berlin/Boston

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