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Issues of gender in injection drug use : examining contextual circumstances of women’s first injecting experience and factors associated with treatment engagement.

University of British Columbia

Women who inject drugs (IDU) are at elevated risk for drug-related harms. While there has been growing interest in first injecting experiences of IDU, less attention has been given to broader socio-cultural, structural and environmental risk conditions in which marginalized women live and injection risk practices and addiction treatment engagement occur. For this thesis, I sought to build on previous research by using gender-based analysis (GBA) to describe the risk environment of IDU women and examine gender differences in circumstances surrounding first injecting experiences and addiction treatment engagement among IDU in Vancouver. Between May 2005 and December 2007, cross-sectional data were drawn from a prospective cohort of 1,436 participants, including 496 women. GBA was used to identify gender differences in circumstances surrounding first injecting experiences and current addiction treatment enrolment. Risk environment, gendered violence and cultural safety conceptual lenses were used to inform the interpretation of findings. Regarding first injection experiences, associations were found between female gender and Aboriginal ancestry, receiving assisted injection, and intimate partner injection drug use as a reason for first injection, whereas syringe borrowing, injecting in public, first taught to inject by self, and curiosity as a reason for first injection were negatively associated with female gender. Current addiction treatment enrolment was reported by 597 (41.6%) participants – 220 women (89 Aboriginal) – and 377 men (69 Aboriginal). Among women age at first injection and having an intimate partner were associated with treatment enrolment, whereas Aboriginal ancestry, homelessness, and frequent heroin injection were negatively associated. Among men, age at first injection was associated, whereas Aboriginal ancestry, homelessness, frequent alcohol and frequent heroin were negatively associated. Methadone was the most common type of addiction treatment reported by both genders. Most common reasons for non-enrolment were ‘don’t feel a need to stop using drugs’ for women, and ‘don’t think treatment programs work for me’ for men. Findings suggest intimate partner power relations are significant factors in mediating women’s drug using risk practices as well as the perceived degree of safety in accessing health services. These findings contribute to existing literature and provide significant implications for practice, policy and future research.

Thesis/Dissertation

eng

Vancouver : University of British Columbia Library

10.14288/1.0069840

Master of Science in Nursing - MSN

Applied Science, Faculty of; Nursing, School of

2010-05

Graduate

DSpace