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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Women and substance use: A qualitative study on sexual and reproductive health of women who use drugs in Delhi, India
BMJ Open, Volume 7, No. 11, Article e018530, Year 2017
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Description
Objectives To explore contextual factors that increase vulnerabilities to negative sexual and reproductive health (SRH) outcomes and possible differences in SRH-related behaviours and the needs of women who use drugs (WUD) through non-injecting and injecting routes. Design Qualitative study design using semi-structured in-depth interviews. Participants Twenty women who injected drugs in the past 3 months and 28 women who reported using drugs through non-injecting routes in the past 1 month. Setting Interviews were conducted at community-based, drop-in centres in Delhi, India. Results Study findings illustrate that WUD were sexually active and had multiple sex partners including clients of sex work. Transient relationships were reported and many participants engaged in unsafe sex. Factors which affected safe sex behaviours included: gender power imbalance, limited agency for decision-making, lack of accurate information for correct self-risk assessment, and being under the influence of drugs. Despite high awareness, low and inconsistent contraceptive use was reported. Some participants were coerced to conceive while a few others reported their inability to conceive. Violence was a key determinant for SRH outcomes. Perception of certain adverse health outcomes (such as infertility) to be 'common and expected among WUD' influenced access to healthcare. Further, healthcare providers' stigmatising attitudes and lack of women-centric services deterred women from uptake of healthcare services. Conclusion Findings highlight that SRH-related behaviours and needs of this group are a complex interplay of multiple determinants which need to be addressed at all levels: individual, family, community and institutional. It is imperative to roll out a 'one-stop-shop' for a comprehensive package of health services. Expansion of existing drop-in-centres could be considered for setting-up community-based women-centric services with appropriate linkage to drug dependence treatment and reproductive health services. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved.
Authors & Co-Authors
Sharma, Vartika
Belgium, Ghent
Universiteit Gent
Sarna, Avina
India, New Delhi
Population Council
Tun, Waimar
United States, New York
The Population Council, Inc.
Saraswati, Lopamudra Ray
India, New Delhi
Population Council
Thior, Ibou
United States, Washington
Path
Madan, Ira
India, New Delhi
Sahara Centre for Residential Care and Rehabilitation
Luchters, Stanley M.F.
Belgium, Ghent
Universiteit Gent
Australia, Melbourne
Burnet Institute
Australia, Clayton
Monash University
Statistics
Citations: 16
Authors: 7
Affiliations: 7
Identifiers
Doi:
10.1136/bmjopen-2017-018530
ISSN:
20446055
Research Areas
Health System And Policy
Sexual And Reproductive Health
Substance Abuse
Study Approach
Qualitative
Participants Gender
Female