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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Examining the gender composition of drug injecting initiation events: A mixed methods investigation of three North American contexts
The International journal of drug policy, v 90, 103056
Apr 2021
PMID: 33310638
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
• We compared the gender composition of injection initiation events across contexts.
• A greater proportion of injection initiation events were gender concordant in Tijuana.
• Prisons and jails may contribute to gender concordant initiation events in Tijuana.
• Intimate partnerships may contribute to gender discordant events in San Diego.
• Caring for others in an overdose crisis may explain the discordance in Vancouver.
Gender influences the health and social risks faced by individuals initiating drug injecting. Using mixed methods across three settings in North America, we investigated the gender composition of injection initiation events and the gendered risk environments in which they occurred.
The PReventing Injecting by Modifying Existing Responses (PRIMER) study pooled data from three prospective community-recruited cohorts of people who inject drugs (PWID) in San Diego, USA, Vancouver, Canada, and Tijuana, Mexico. A qualitative subsample provided narrative data on their experiences of, and the contexts for, injection initiation events. Guided by Rhodes’ risk environment framework, we examined the gender composition of initiation events stratified by city, and analyzed qualitative data using abductive thematic analyses.
Among 2,622 PWID (Tijuana: n = 531; San Diego: n = 352; Vancouver: n = 1,739), 112 (4.3%) reported providing initiation assistance to injection-naïve individuals in the previous six months. The proportion of gender concordant (e.g., male-male) initiation pairs varied, (χ2 = 10.32, p <0.001) with greater than expected concordance among pairs in Tijuana compared with those in Vancouver or San Diego. Sixty-one interviews provided context for the discrepancy across sites by highlighting the gendered injection initiation risk environments of prison/jail detention in Tijuana, intimate partnerships in San Diego, and overdose risk in Vancouver.
These results highlight how gender influences injection initiation events within spatial, social, and economic risk environments, and how this influence varies across settings. These findings can inform interventions to reduce the risk of injection initiation and related harms.
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Details
- Title
- Examining the gender composition of drug injecting initiation events: A mixed methods investigation of three North American contexts
- Creators
- Meyers SA - San Diego State UniversityRafful C - Universidad Nacional Autónoma de MéxicoMittal ML - University of California San DiegoSmith LR - University of California San DiegoTirado-Muñoz J - University of California San DiegoJain S - University of California San DiegoSun X - University of California San DiegoGarfein RS - University of California San DiegoStrathdee SA - University of California San DiegoDeBeck K - British Columbia Centre on Substance UseHayashi K - British Columbia Centre on Substance UseMcNeil R - Yale School of MedicineMilloy MJ - British Columbia Centre on Substance UseOlding M - British Columbia Centre on Substance UseGuise A - King's College LondonWerb D - University of California San DiegoScheim AI - University of California San DiegoSonali Jain - Sociology
- Publication Details
- The International journal of drug policy, v 90, 103056
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Sociology; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000695284400009
- Scopus ID
- 2-s2.0-85097551431
- Other Identifier
- 991019167568904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Substance Abuse