Abstract
BackgroundWomen who inject drugs (WWID) experience unique risks and adverse health outcomes related to injection initiation and patterns of injection drug use. However, there is limited information on injection initiation experiences and injection patterns among women and the protective strategies employed to limit injection-related harms, especially in low- and middle-income settings. Therefore, this study sought to explore injection initiation and current injection patterns (e.g., relying on someone else to inject) among women who inject drugs and engage in sex work in Tijuana, Mexico.MethodsSemistructured in-depth interviews were conducted with 30 WWID on the following topics: injection initiation, current injection patterns, places where women inject, and protective strategies (i.e., risk reduction). All interviews were audio-recorded, transcribed, and de-identified. An inductive thematic analysis was conducted to identify and compare common themes and patterns across participants.ResultsThe interviews revealed that the vast majority of study participants were first initiated by another person who injects drugs (PWID), often a male sexual partner. However, the majority of the women transitioned to become self-injectors in order to avoid risks associated with relying on others for injection, including overdose, interpersonal violence, sexual abuse, and wounds. Those who relied on others indicated that they would prefer to inject themselves without assistance from others if they were able to.ConclusionsThe narratives uncovered in this study reveal the importance of multiple risk environments in shaping perceived risks associated with injection drug use among women in Tijuana, Mexico. Specifically, the interviews elucidate the connection between interpersonal relationships with other PWID and protective strategies used to minimize risk and harm. These findings highlight the need for women-centered harm reduction programs to facilitate the development of safer drug use environments among WWID in Tijuana, Mexico.
Highlights
Women who inject drugs (WWID) experience unique risks and adverse health outcomes related to injection initiation and patterns of injection drug use
Background women who inject drugs (WWID) comprise only 20% of all people who inject drugs (PWID) globally, they face a myriad of gender-specific risks including
WWID globally face an array of gender-specific risks shaped by diverse contextual factors and structural determinants
Summary
Women who inject drugs (WWID) experience unique risks and adverse health outcomes related to injection initiation and patterns of injection drug use. Stewart et al Harm Reduct J (2021) 18:105 intimate partner violence, intersections between sex work and drug use, and social and economic marginalization [1,2,3] These factors may contribute to injection initiation, increased risk from injection patterns, and other adverse health outcomes associated with injection drug use [2, 4,5,6]. Prior research has shown that WWID tend to be at higher risk of acquiring HIV, other sexually transmitted infection (STIs), and hepatitis C compared to MWID These gender disparities may be attributed to the overlap between drug use and sex work and a reliance on male partners for drug acquisition, preparation, and injection [6,7,8]. Rates of gender-based and intimate partner violence have been found to be two to five times higher among WWID compared to women who do not use drugs [9]; such experiences place women at greater risk for HIV/STI and other health-related harms
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
