Abstract
IntroductionStudies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. Crack use is prevalent in Brazil; however, few comparative data by sex exist. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18–24 years), regular and marginalized crack users in Brazil.MethodsStudy participants (total n = 159; n = 124 males and n = 35 females) were recruited by community-based methods from impoverished neighborhoods in Rio de Janeiro and Salvador. Assessments occurred by an anonymous interviewer-administered questionnaire and serum collection for blood-borne virus testing between November 2010 and June 2011. Descriptive statistics and differences for key variables by sex were computed; in addition, a ‘chi-squared automatic interaction detector’ (‘CHAID’) analysis explored potential primary factors differentiating male and female participants.ResultsMost participants were non-white, and had low education and multiple income sources. More women had unstable housing and income from sex work and/or panhandling/begging, whereas more men were employed. Both groups indicated multi-year histories of and frequent daily crack use, but virtually no drug injection histories. Men reported more co-use of other drugs. More women were: involved in sex-for-drug exchanges; Blood-Borne Virus (BBV) tested and HIV+. Both groups reported similar physical and mental health patterns; however women more commonly utilized social or health services. The CHAID analysis identified sex work; paid work; begging/panhandling; as well as physical and mental health status (all at p < 0.05) as primary differentiating factors by sex.ConclusionsCrack users in our study showed notable differences by sex, including socio-economic indicators, drug co-use patterns, sex risks/work, BBV testing and status, and service utilization. Results emphasize the need for targeted special interventions and services for males and female crack users in Brazil.
Highlights
Studies have shown important gender differences among drug users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use
This paper examined gender-specific drug use, health, socio-economic and service use characteristics – and explored potential differences between males and females – among a community-recruited bi-site sample of young, regular crack users in Brazil
Assessments consisted of an interviewer-administered questionnaire with 31 mainly quantitative items on socio-demographic, health and drug use characteristics, and service use/needs; in addition, blood specimens were collected by venipuncture and subsequently tested for Hepatitis B antigen (HBAg), anti-HBc total, anti-HBs, total anti-HAV, anti-Hepatitis C virus (HCV), and anti-Human immunodeficiency virus (HIV) using commercial enzyme immunoassays
Summary
Studies have shown important gender differences among drug (including crack) users related to: drug use patterns; health risks and consequences; criminal involvement; and service needs/use. We examined and compared by sex key drug use, health, socio-economic indicators and service use in a bi-city sample of young (18–24 years), regular and marginalized crack users in Brazil. While women are typically less involved in substance use-related overt deviance (e.g., violence or crime), data from several studies suggest higher levels of co-morbid psychological or psychiatric problems among women users; large (30%–50%) proportions of women substance users report a history of (sexual or other) trauma and/or related Post-traumatic stress disorder (PTSD) [1,2,8]. Larger proportions of women indicate co-morbid mood (e.g., depression) and/or anxiety disorders; the evidence is inconsistent about the directionality or sequence of these co-morbidities [1,9,10,11]
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