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PubMedDate not supplied

The incidence and experience of rape among chemically dependent women.

This descriptive study investigated the incidence and experience of rape among chemically dependent women. Sixty women in a residential treatment facility were interviewed about sexual trauma they had experienced in their lives. In this sample 73% had been raped, and 45% had been raped more than once. The stories of rape were classified in five categories: rape while in the context of using, when too high to resist, while prostituting, by a significant other, and by a family member. Some 35% of the rapist described were friends of the women with whom they were using drugs. Only 20% of the rapes were reported to the police. Clinical implications for treatment of addicted women who are also survivors of violence is discussed.

Adult↗
PubMedDate not supplied

Criminality among female drug abusers.

Criminality among female (n=351) drug abusers is compared to that of men (n=798) as part of a longitudinal study of persons in treatment in Sweden (the SWEDATE project). The extent of criminality was much less among females than among males, and fewer women than men were criminal. The pattern of criminality varied between the sexes. Women's crime debuts occurred later, and they committed less violent crimes and more drug-related crimes. The majority of women supported themselves in other ways than with criminality. Also, women tended to have a more severe pattern of abuse, a more rapid drug career, and more complex psychological problems than men. A subgroup of prostitutes whose drug of choice was heroin often began drug use early with cannabis and went on to amphetamine for their first injection, which often took place in a junkie pad. There was also a criminal group (as there was among men) with a very early and intensive juvenile delinquency pattern, early drug debuts and a rapid transition to regular abuse and extensive adult criminality. Forty-two percent of the women had no criminal records; they had more extensive multiple drug abuse than the other women (this was also true for the noncriminal male addicts). The study shows that drug abuse and criminality are interrelated for certain individuals, but not for others.

Adolescent↗
PubMedDate not supplied

Drug use, street crime, and sex-trading among cocaine-dependent women: implications for public health and criminal justice policy.

The linkages between the sex-for-crack exchanges, prostitution, and rising rates of HIV and other sexually transmitted diseases among cocaine-dependent women have been well documented. As crack began to disappear from the headlines during the 1990s, however, it was assumed by many that crack had fallen on hard times in the street drug culture. Within this context, this article examines the extent to which crack has remained primary in the culture of cocaine-dependent women. Data are drawn from a study of 708 cocaine-dependent women in Miami, Florida, during the years 1994 to 1996, and qualitative data gathered during 1998 and 1999 in the same field areas. Analyses focus on drug use, criminality and HIV/AIDS risk behaviors. Implications for policy alternatives in criminal justice and public health approaches for assisting this population are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Effects of gender and diagnosis on addiction history, treatment utilization, and psychosocial functioning among a dually-diagnosed sample in drug treatment.

There has been increased recognition of the clinical treatment needs of patients with co-occurring mental and substance use disorders and the heterogeneity of this group with regard to types of substances used and mental disorders. This article examines differences between men and women diagnosed with mood or psychotic disorders at admission to residential drug treatment, specifically regarding their addiction history, treatment history, perceived service needs, and psychosocial functioning. Males initiated drug use at a younger age and had higher levels of dependence on alcohol, cannabis, and opioids. There were no differences among groups in treatment history, motivation, or initiation. Males had higher rates of being under legal supervision and engaging in property crime, whereas females had higher rates of prostitution. Females had greater needs for family- and trauma-related services, and females with psychotic disorders had the highest needs for basic services. There were no differences among groups in barriers to treatment, quality of life, self-efficacy, or family support. Individuals with psychotic disorders had more symptoms of psychological distress; females had higher rates of posttraumatic stress disorder. Differences among dually-diagnosed individuals related to gender and diagnosis need to be considered in treatment planning and in matching services to patient needs.

Adolescent↗
PubMed2006

Drug users' participation in addiction care: different groups do different things.

This study allocated 201 (nearly) daily users of heroin and/or crack into four groups, depending on their addiction care participation. Earlier studies have compared treatment groups and nontreatment groups. In this study the treatment group is divided into three categories: (1) drug users in contact with only treatment agencies--i.e., methadone maintenance, clinical and ambulant drug treatment; (2) drugs users in contact with only care agencies--i.e., day and night shelters and drug consumption rooms, which have no explicit aims to change patterns of drug use; and (3) drug users in contact with both treatment and care agencies. This allocation intro three different groups fits the notion of harm reduction, one of the policy aims in The Netherlands. The fourth group consists of drug users in contact with neither treatment nor care agencies. The results show that it is useful to distinguish these four categories, instead of two. The four groups are different from each other with respect to some of their characteristics (e.g. debt situation, prostitution, homelessness) and their drug use (e.g. drug use in public, use of crack, and use of other drugs). A much clearer distinction can be made between the "care" group and the "treatment and care" group. Treatment and care agencies can thus better match their services to their clients or patients.

Adult↗
PubMedDate not supplied

Sexual networking of market women in Benin City, Edo State, Nigeria.

The manifestation of acquired immune deficiency syndrome (AIDS) all over the world has increased the need for information on the nature and pattern of sexual networking in Africa, where there is a dearth of such information. In the present study, information on the sexual networking of market women in Benin City, Nigeria, was obtained using a questionnaire instrument. The questionnaire covered the sexual, reproductive, and health behaviors of these women. The data revealed that the levels of both premarital and extramarital sexual networking are high. Such a high degree of sexual networking has exposed a number of these women to sexually transmitted diseases. The manifestation of AIDS in this society will be widespread and devastating to the people and the society because these women are in a polygamous relationship in a society that frowns on the use of contraceptives by couples. In addition, controversies surround the correlation between socioeconomic status (SES) and AIDS, geographical areas of prevalence, and the role of prostitutes in the spread of the disease. For example, studies in Africa show that whereas there is no correlation between SES and AIDS in Kinshasa, the attack rate was higher in educated people in Rwanda and Zambia. Moreover, there are predominantly urban outbreaks in other countries, such as Uganda (Piot & Carael, 1988).

Acquired Immunodeficiency Syndrome↗
PubMed1999

The effects of economic circumstances on British students' mental and physical health.

Three-hundred sixty British university students completed a questionnaire providing information on demographic characteristics, financial circumstances, smoking, and drug and alcohol use. A 14-item inventory of physical symptoms, the short form 36 health survey (SF-36), and the General Health Questionnaire (GHQ-12) were used to assess their physical and psychological well-being. Except for physical functioning, all subscales of the SF-36 and the GHQ indicated levels of health significantly below population norms matched for age and sex. Poorer mental health was related to longer working hours outside the university and difficulty in paying bills. Students who had considered abandoning study for financial reasons had poorer mental health, lower levels of social functioning and vitality, and poorer physical health as indicated by variables on the SF-36. They were also heavier smokers. Students' personal debt was significantly associated with their knowing people involved in prostitution, crime, or drug dealing to help support themselves financially.

Adult↗
PubMedDate not supplied

Health services in Vietnam.

This paper reviews the existing health services in Vietnam against the background of 50 years of wars with Japan, France, the United States and neighbouring countries, leaving a devastated economy and thousands of war-wounded, prostitutes, drug addicts and orphans. Defoliation has affected soil fertility and caused miscarriages, stillbirths and deformities. Unexploded bombs still blow off peasants' legs. The prevalence of malaria is increased by the many bomb craters where mosquitoes breed in stagnant water. Superstitions in some ethnic groups contribute to childhood malnutrition. A system is being developed of large provincial hospitals, 100-bed district hospitals and village clinics, incorporating traditional medicine. These are well staffed but poorly equipped. Modern medical and surgical equipment and medicines are urgently needed, but will have to be provided by humanitarian aid until trade links are restored.

Health Services↗
PubMed2005

Mother-to-child transmission of HIV infection in Romania: results from an education and prevention programme.

A pilot prevention of mother-to-child transmission (PMTCT) programme was implemented in Constanta County, Romania, between 2000 and 2002. The programme consisted of clinician training, routine antenatal HIV counselling and testing and the care of HIV-infected pregnant women and their infants. A total of 11,423 pregnant women (10,192 (89%) white Europeans, 862 (7.5%) Rroma, 369 (3.2%) Central Asians) were tested during the pilot, at a median of 24 weeks' gestation. Rapid HIV testing at delivery was introduced during the pilot, to supplement the antenatal testing, both of which required informed consent. Overall seroprevalence was 1.75 per 1,000 (95% confidence interval (CI) 1.07-2.70 per 1,000). HIV infection was associated with having a high-risk partner, prostitution and non-Caucasian ethnicity. Twelve infected women completed their pregnancies, of whom seven received antenatal antiretroviral therapy (ART); all neonates received prophylactic ART and five were delivered by elective caesarean section. Three infants were HIV-infected, giving a vertical transmission rate of 25% (95% CI 5.49-57.2%); all three were born to mothers not identified as infected until delivery, and who therefore received no antenatal ART. A key challenge for PMTCT in Romania will be the prompt identification of pregnant HIV-infected women, to allow the optimum application of interventions.

Adolescent↗
PubMed1990

An ethnographic study of HIV-related risk practices among Glasgow rent boys and their clients: report of a pilot study.

This paper provides an early report of a continuing ethnographic study of male prostitution in Glasgow. Pilot work indicates that rent boy activity may be of considerable importance for the spread of HIV infection. Although there is little evidence of an association between rent boy activity and injecting drug use, rent boys may well be implicated in epidemic spread because many (but not all) of them report unsafe sexual practices. Some boys reported that they engaged in unprotected anal sex both actively (insertor) and passively (insertee). Although the majority of the boys' clients were covert bisexuals--married men seeking occasional, anonymous, male sexual contact--a substantial minority of clients were gay-identified.

Adolescent↗
PubMed1991

Limited changes in sexual behaviour of heterosexual men and women with multiple partners in The Netherlands.

To study changes in sexual behaviour, heterosexuals with multiple sexual partners were recruited through an STD-clinic and asked to return every 4 months for follow-up. Between October 1987 and June 1989, 512 heterosexuals entered the study and 140 men and 200 women had at least one follow-up visit. No changes were found between 3 visits in the kind of sexual techniques practiced. Condom use during vaginal intercourse with commercial partners (prostitutes or clients) was relatively high and remained high, but was low and remained at that level with private partners. Men and women reduced their number of private sexual partners by 50%, but the decline in the number of commercial partners was nonsignificant. Although more information is needed about the underlying social-psychological aspects of behavioural change, it seems necessary to redesign prevention activities to stress the effectiveness of condoms and to encourage condom use especially among heterosexuals with multiple private partners.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HIV prevalence and HIV risk behaviour among injecting drug users in London and Glasgow.

This paper reports on the British findings from a cross-national study of HIV prevalence and HIV risk behaviour among 1,037 injecting drug users (IDUs) recruited from a variety of treatment- and community-based settings during 1990. Confirmed HIV saliva test results show 12.8% (63) of London respondents and 1.8% (8) of Glasgow respondents to be HIV antibody positive. Among London respondents, a higher rate of prevalence was found in those with no experience of drug treatment. A greater proportion of Glasgow respondents (68%) than London respondents (47%) reported sharing used injecting equipment in the 6 months prior to interview. The majority (88% in both cities) attempted cleaning borrowed equipment, although less than a third (31% in London and 30% in Glasgow) usually used bleach. The majority of respondents (71% in London and 82% in Glasgow) were sexually active with partners of the opposite sex in the last 6 months, and respondents had a mean number of 2.4 non-commercial sexual partners in London and 2.1 in Glasgow. Levels of reported condom use were comparable with reports in the heterosexual population as a whole, with 70% of London respondents and 75% of Glasgow respondents never using condoms with primary partners, and 34% of London and 52% of Glasgow respondents never using condoms with casual partners. Half (48%) of London respondents and 42% of Glasgow respondents reported sexual intercourse with non-injecting private sexual partners, while 14% of female respondents in London and 22% in Glasgow had engaged in prostitution. Levels of risk-taking in each of the two cities indicate the potential for further transmission of HIV among drug injectors, and their sexual and sharing partners.

Adult↗
PubMed1993

Sexual issues and condom use among injecting drug users.

Recent surveys of injecting drug users reveal that their injecting behaviours have changed in the light of HIV, but their sexual behaviours have not and, in particular, they remain reluctant to use condoms to reduce the risks of sexual transmission. In an attempt to explore this issue further the present study assessed the behaviours and attitudes of injecting drug users to sexual issues, including condom use. Condom use was low. Obstacles to their use included for some a desire to conceive, for many a belief in their infertility, a perceived invulnerability to HIV infection through their sexual behaviour patterns, a dislike of condoms and difficulty in negotiating condom use with partners. The lifestyle of drug users may also have an influence on condom use. Many drug users funded their habit through illegal activities including prostitution, theft and fraud. The association between these and other factors and condom use are explored.

Adult↗
PubMed1993

Severity of heroin dependence and HIV risk. I. Sexual behaviour.

The HIV risks associated with the sexual behaviour of drug injectors have sometimes been overshadowed by the more obvious risks of injection behaviour. In this study, 408 heroin users were interviewed in the community; 50% were not currently in treatment and 42% had never had any treatment contact. In addition to data on drug use, information was collected on sexual risk behaviour by means of a linked anonymous questionnaire (96% returned). Eighty-nine per cent of the sample had had at least one sexual partner in the previous year and 58% had a regular sexual partner at the time of interview. Drug users who had a sexual partner who was injecting drugs were more severely dependent upon heroin. Twenty-three per cent of the men and 20% of the women reported having had anal intercourse in the previous year. Seventeen per cent of the women and 6% of the men had engaged in some form of prostitution. Severity of heroin dependence was positively related to the occurrence and to the frequency of sex-for-money transactions and to the less well recognized phenomenon of sex-for-drugs; this association with severity of dependence applied to the women and to the men who have sex with men. The overall level of condom use was low in this sample, though condom use was more frequent among those involved in sex-for-money or sex-for-drugs transactions. Low levels of condom use were reported even for such high risk activities as anal sex.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

HIV infection among injecting drug users in north-east Malaysia, 1992.

Human immunodeficiency virus (HIV) has spread widely among injecting drug users (IDUs) in countries to the north and west of the 'Golden Triangle' region of South-East Asia; it is likely to have spread southwards to Malaysia as well. In order to assess HIV seroprevalence among IDUs in north-east Malaysia and describe risk factors for HIV infection in this population, we performed a cross-sectional seroepidemiological study among 210 IDUs recruited at the detoxification ward of the General Hospital in the capital city of the north-eastern Malaysian state, Kelantan. Subjects were sequential entrants to the detoxification ward, interviewed about HIV risk behaviour, and tested for antibody to HIV and to syphilis. Nearly a third (62/210, 30%) of these IDUs were HIV seropositive. Three-quarters (159/210) had travelled to Thailand in the preceding 5 years, of whom 32% (51/159) were HIV seropositive; this was associated with injecting in Thailand, but not with sexual contact there. Of those who had not left Malaysia in the preceding 5 years, 26% (11/43) were HIV seropositive, a rate not significantly different from those who had travelled. Travel within Malaysia was common (144/210, 69%) among IDUs interviewed, as was unsafe injecting and unsafe sexual behaviour (20% had shared injecting equipment and 21% had had unprotected intercourse) in other states. In every locale, rates of unsafe injecting behaviour were high (55% sharing in last month), even among those who knew they were HIV infected, and rates of condom usage were low (93% of 160 sexually active IDUs had never used a condom). Syphilis was not associated with HIV infection, but with contact with Thai prostitutes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

HIV-related knowledge and attitudes among medical students in China.

A modified version of the 'WHO/KABP Questionnaire for Students' was administered to 302 students at a medical university in China. The instrument included items to assess the students' demographic background, knowledge of AIDS/HIV, attitudes about AIDS, as well as towards people infected with HIV, those groups commonly labelled as 'high risk' and toward sources of information. The average score on the knowledge scale was 80% correct. There was a substantial disparity in knowledge between how HIV is transmitted and how HIV is not transmitted--90% of the former items were answered correctly, while only 72% of the latter were answered correctly. Over 40% of the sample blamed prostitutes for AIDS in China, whereas 22% blamed drug addicts and 6% blamed homosexuals. Two-thirds of the sample indicated that they thought people with AIDS got what they deserve. About one-third of the sample supported quarantine measures as well as keeping infected students out of classrooms. Nearly half of the sample indicated that they did not trust any of the official sources of health information we asked about and 27% said that they thought the government was concealing information about AIDS.

Adolescent↗
PubMed1995

AIDS awareness among a cohort of young Thai men: exposure to information, level of knowledge, and perception of risk.

Structured interviews and focus group discussions were conducted among 834 young Thai men drafted into military service by random lottery in northern Thailand. Level of AIDS risk, exposure to AIDS information, level of knowledge about AIDS, and perception of risk for acquiring HIV and AIDS were assessed at baseline and six months after induction into the Army in 1991. General fear of AIDS was high, yet personal perception of risk for acquiring HIV was low, even for those at enhanced behavioural risk of infection with HIV. Multivariate PATH analysis shows that exposure to information about AIDS significantly reduced risk taking from baseline to follow-up, but only by first affecting personal risk perception. Focus group discussions revealed that risk perception for acquiring AIDS was low due to never knowing a person with AIDS, because prostitutes had health certificates for STD, and since many believed that AIDS could be cured or prevented with folk medicines. Implications and recommendations for intervention programmes are discussed.

Adult↗
PubMed1996

A primary health care service for Glasgow street sex workers--6 years experience of the "drop-in centre', 1989-1994.

In Glasgow, a health and social care centre opened in 1988 principally to facilitate HIV prevention among street prostitutes, most of whom are injecting drug users. During 1992 to 1994, 551 women made 17,554 visits to the medical room which is functional 5 nights per week. The mean age of the sex workers was 26 years (range 15 to 62) and 89% injected drugs. Fifty-five per cent of the attendances were for needle/syringe exchange only whilst the remainder involved other health care provision. Common presenting problems included abscesses, burns and venous thromboses, reflecting the high proportion of sex workers who injected drugs. Most women always used condoms for penetrative commercial sex and symptomatic sexually transmitted disease was seen infrequently. In addition to the provision of injecting equipment and condoms, other key prevention activities included Hepatitis B vaccination and cervical screening. The prevalence of HIV infection amongst the women remains under 5% and most seropositives were known to be infected before the Centre opened. This initiative shows that if multidisciplinary health and social services are provided to street sex workers at a time and place convenient to their work, the benefits are considerable.

Adolescent↗