scholarly journals Slipping through: mobility’s influence on infectious disease risks for justice-involved women in Canada

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Susie Taylor ◽  
Margaret Haworth-Brockman ◽  
Yoav Keynan

Abstract Background The relationship between incarceration and women’s vulnerability to sexually transmitted and blood-borne infections (STBBI) is understudied in Canada, despite numerous studies showing that justice-involved women experience very high rates of infection. Justice-involved women in Canada are highly mobile, as a result of high rates of incarceration and extremely short sentences. From a public health perspective, it is productive to understand how the mobility of justice-involved women shapes their vulnerability to STBBI. Results This narrative review demonstrates that mobility between incarceration facilities and communities drives sexually transmitted and blood-borne disease risk for justice-involved women in Canada. Associations and interactions between epidemics of gender-based and intimate partner violence, substance use, and STBBIs shape the experiences of justice-involved women in Canada. In correctional facilities, the pre-existing vulnerability of justice-involved women is compounded by a lack of comprehensive STBBI care and limited harm reduction services. On release, unstable housing, disruptions to social support networks, interruptions in medical care, and relapse to or continuation of substance use, significantly increase individual disease risk and the likelihood of community transmission. High rates of incarceration for short periods perpetuate this cycle and complicate the delivery of healthcare. Conclusions The review provides evidence of the need for stronger gender-transformative public health planning and responses for incarcerated women, in both federal and provincial corrections settings in Canada. A supportive, evidence-based approach to STBBI identification and treatment for incarcerated women - one that that removes stigma, maintains privacy and improves access, combined with structural policies to prevent incarceration - could decrease STBBI incidence and interrupt the cycle of incarceration and poor health outcomes. A coordinated and accountable program of reintegration that facilitates continuity of public health interventions for STBBI, as well as safe housing, harm reduction and other supports, can improve outcomes as well. Lastly, metrics to measure performance of STBBI management during incarceration and upon release would help to identify gaps and improve outcomes for justice-involved women in the Canadian context.

2018 ◽  
Vol 24 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Vijaya Murali ◽  
Sabitha Jayaraman

SummaryIt has long been recognised that substance use disorders and sexually transmitted infections (STIs) are common comorbid conditions. It is clear that treating one condition while leaving the other leads to increased morbidity and mortality in this patient population. However, engaging patients in treatment is extremely challenging, which is a huge public health concern. This article focuses on various sexually transmitted infections seen in the substance misuse population and means of primary, secondary and tertiary prevention.Declaration of interestNone.Learning objectives•Be aware of the current extent of comorbidity between substance use disorders and STIs•Learn about primary, secondary and tertiary prevention of STIs in people with substance use disorders•Understand the links between high-risk sexual behaviour and illicit drug use, as shown by current evidence


Author(s):  
Shilo St. Cyr ◽  
Elise Trott Jaramillo ◽  
Laura Garrison ◽  
Lorraine Halinka Malcoe ◽  
Stephen R. Shamblen ◽  
...  

Intimate partner violence (IPV) is a common feature in the lives of incarcerated women returning to rural communities, enhancing their risk of mental ill-health, substance use, and recidivism. Women’s experiences of IPV intersect with challenges across multiple social–ecological levels, including risky or criminalizing interpersonal relationships, geographic isolation, and persistent gender, racial, and economic inequities. We conducted quantitative surveys and qualitative interviews with 99 incarcerated women in New Mexico who were scheduled to return to micropolitan or non-core areas within 6 months. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. The findings underscore how individual and interpersonal experiences of IPV, substance use, and psychological distress intersect with broad social inequities, such as poverty, lack of supportive resources, and reluctance to seek help due to experiences of discrimination. These results point to the need for a more proactive response to the mutually constitutive cycle of IPV, mental distress, incarceration, and structures of violence to improve reentry for women returning to rural communities. Policy and treatment must prioritize socioeconomic marginalization and expand community resources with attention to the needs of rural women of color.


Sexes ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 509-522
Author(s):  
Andreea C. Brabete ◽  
Lindsay Wolfson ◽  
Julie Stinson ◽  
Nancy Poole ◽  
Sarah Allen ◽  
...  

Rates of intimate partner violence (IPV) and substance use have risen during the COVID-19 pandemic, with potentially enduring effects on women’s health. A rapid review was conducted on IPV and women’s substance use in the context of the COVID-19 pandemic. The rapid review explored two separate research questions with a view to integrate the literature related to: (1) containment, social isolation, pandemics, disasters, lockdowns, and IPV; and (2) the relationships between substance use and IPV. Two different searches for each question were conducted between May and October 2020 and n = 47 articles were included. Women experience multiple physical and mental health consequences related to IPV that can be exacerbated by public health crises such as pandemics and disasters. Perpetrators may use these events as a tactic to threaten, isolate, or use coercive control. Similar tactics are reported in the complex relationship between IPV and substance use, where substance use can accompany IPV and/or be used as a coping mechanism for survivors. The findings highlight long standing women’s health concerns made further visible during the COVID-19 pandemic. Additional research is needed to identify actions required to reduce gender inequities and harms associated with IPV and substance use, and to adequately tailor and prepare effective responses in the context of future public health crises.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028583 ◽  
Author(s):  
Pamela Leece ◽  
Triti Khorasheh ◽  
Nimitha Paul ◽  
Sue Keller-Olaman ◽  
Susan Massarella ◽  
...  

ObjectivesWe sought to understand the implementation of multifaceted community plans to address opioid-related harms.DesignOur scoping review examined the extent of the literature on community plans to prevent and reduce opioid-related harms, characterise the key components, and identify gaps.Data sourcesWe searched MEDLINE, Embase, PsycINFO, CINHAL, SocINDEX and Academic Search Primer, and three search engines for English language peer-reviewed and grey literature from the past 10 years.Eligibility criteriaEligible records addressed opioid-related harms or overdose, used two or more intervention approaches (eg, prevention, treatment, harm reduction, enforcement and justice), involved two or more partners and occurred in an Organisation for Economic Co-operation and Development country.Data extraction and synthesisQualitative thematic and quantitative analysis was conducted on the charted data. Stakeholders were engaged through fourteen interviews, three focus groups and one workshop.ResultsWe identified 108 records that described 100 community plans in Canada and the USA; four had been evaluated. Most plans were provincially or state funded, led by public health and involved an average of seven partners. Commonly, plans used individual training to implement interventions. Actions focused on treatment and harm reduction, largely to increase access to addiction services and naloxone. Among specific groups, people in conflict with the law were addressed most frequently. Community plans typically engaged the public through in-person forums. Stakeholders identified three key implications to our findings: addressing equity and stigma-related barriers towards people with lived experience of substance use; improving data collection to facilitate evaluation; and enhancing community partnerships by involving people with lived experience of substance use.ConclusionCurrent understanding of the implementation and context of community opioid-related plans demonstrates a need for evaluation to advance the evidence base. Partnership with people who have lived experience of substance use is underdeveloped and may strengthen responsive public health decision making.


2020 ◽  
Author(s):  
Mbuzeleni Hlongwa ◽  
Karl Peltzer ◽  
Khumbulani Hlongwana

Abstract Background: Despite several intervention programmes in South Africa, risky sexual behaviours among women of reproductive age remain a public health concern, thereby making them prone to unintended pregnancies, human immunodeficiency virus (HIV) infection and/or sexually transmitted infections (STIs). This study investigated the predictors of risky sexual behaviours among women of reproductive age in a high HIV burdened township in KwaZulu-Natal (KZN), South Africa.Methods: This was a cross-sectional study conducted among 471 women of reproductive age (18-49 years, mean: 25.83) in 10 public health clinics in Umlazi township, using a structured questionnaire. Data were coded, entered into Epi Data Manager and exported to Stata for analysis. A Pearson Chi-square test and logistic regression models (bivariate and multivariate) were employed to assess the level of the association between the predictor and outcome variables and the p-value 0.05 or lower was considered statistically significant.Results: More than half (51.80%) of women were aged 18-24 years and only a handful (18.26%) had tertiary qualification. The majority were single (88.96%) and the unemployed accounted for 53.50%. This study found that women who talked about condoms with their partners in the past 12 months were more likely (p=<0.0001) to have used condoms during their last sexual experience. Older women (p=0.035) were more likely to use a condom at last sex, compared to younger women. However, women who were exposed to physical partner violence (hitting and/or slapping), those who had ever been diagnosed with HIV and those whose sexual partners were diagnosed with HIV, did not show a significant association with condom use during last sexual experience.Conclusion: Exposure to physical partner violence and poor partner discussions about condoms are key deterrents to condom usage. Holistic interventions are required in order to address the risky behaviours, and consequently reduce sexually transmitted infections and/or unintended pregnancies.


Author(s):  
Elena Cyrus ◽  
Jorge Sanchez ◽  
Purnima Madhivanan ◽  
Javier R. Lama ◽  
Andrea Cornejo Bazo ◽  
...  

Background: Globally, there is evidence supporting the co-occurrence of intimate partner violence (IPV), substance use disorders (SUD) and mental health disorders among women in prisons, however, there is limited research investigating these domains in the Andean region where rates of female incarceration have increased. The study objective was to explore the prevalence of IPV, SUD and depression among incarcerated women in a Peruvian prison and explore associations among these variables and related correlates. Methods: 249 incarcerated women responded to a questionnaire about IPV, substance use, depression, and sexual behavior, and were screened for HIV/sexually transmitted diseases (STDs). Univariate analysis and logistic regression were used to estimate relative risk and the influence of substance use and depression on IPV rates. Results: Twelve months prior to incarceration, of the women with sexual partners pre-incarceration (n = 212), 69.3% experienced threats of violence, 61.4% experienced ≥1 acts of physical violence, and 28.3% reported ≥1 act of sexual aggression. Pre-incarceration, 68.1% of drug-using women had a SUD, and 61.7% of those who consumed alcohol reported hazardous/harmful drinking. There were 20 (8.0%) HIV/STD cases; and 67.5% of the women reported depressive symptoms. Compared to women with no experiences of physical violence, a greater proportion of women who experienced least l violent act had depressive symptoms and engaged in sex work pre-incarceration. Depression was associated with physical violence (adjusted relative risk = 1.35, 95% confidence interval: 1.14–1.58). Recommendations: The findings provide evidence of a syndemic of IPV, substance abuse and depression among incarcerated women in a Peruvian prison. To help guide policy makers, further research is needed to determine if this is indicative of trends for other at-risk women in the region, and viable options to treat these women during incarceration to prevent recidivism and other long-term negative sequalae.


2022 ◽  
pp. 088626052110520
Author(s):  
Diane S. Morse ◽  
Catherine Cerulli ◽  
Melissa Hordes ◽  
Nabila El-Bassel ◽  
Jacob Bleasdale ◽  
...  

The presence and severity of childhood and adult victimization increase the likelihood of substance use disorder (SUD), crimes, antisocial behaviors, arrests, convictions, and medical and psychiatric disorders among women more than men. These problems are compounded by the impact of social determinants of health (SDH) challenges, which include predisposition to the understudied, dramatic increase in opioid dependence among women. This study examined victimization, related SDH challenges, gender-based criminogenic risk factors for female participants, and public health opportunities to address these problems. We recruited women from the first national Opioid Intervention Court, a fast-track SUD treatment response to rapidly increasing overdose deaths. We present a consensual qualitative research analysis of 24 women Opioid Intervention Court participants (among 31 interviewed) who reported childhood, adolescent, and/or adult victimization experiences in the context of substance use and recovery, mental health symptoms, heath behaviors, and justice-involved trajectories. We iteratively established codes and overarching themes. Six primary themes emerged: child or adolescent abuse as triggers for drug use; impact of combined child or adolescent abuse with loss or witnessing abuse; adult abduction or assault; trajectory from lifetime abuse, substance use, and criminal and antisocial behaviors to sobriety; role of friends and family support in recovery; and role of treatment and opioid court in recovery, which we related to SDH, gender-based criminogenic factors, and public health. These experiences put participants at risk of further physical and mental health disorders, yet indicate potential strategies. Findings support future studies examining strategies where courts and health systems could collaboratively address SDH with women Opioid Intervention Court participants.


Author(s):  
C. Vassalle ◽  
L. Sabatino ◽  
A. Pingitore ◽  
K. Chatzianagnostou ◽  
F. Mastorci ◽  
...  

This review aims to focus on main antioxidants- abundantly contained in the diet- as well as of the whole Mediterranean diet and life-style and their relationship with cognitive function, especially critical in two phases of life, in children until adolescence and oldness. The role of emerging biochemical and molecular biomarkers as opportunity to estimate more accurately nutritional assumption and requirement, in terms of cognitive preservation and disease risk, will be also discussed. The cluster of factors within the Mediterranean pattern -which include not only nutritional, but also physical, social, and stimulating aspects- is still largely understudied as a whole, but it is proposed as attractive research area and tool for public health planning of prevention and intervention.


Partner Abuse ◽  
2015 ◽  
Vol 6 (3) ◽  
pp. 337-350 ◽  
Author(s):  
Sarah Morton ◽  
Melinda Hohman ◽  
Amanda Middleton

There has been growing recognition of the co-occurrence of substance use and intimate partner violence (IPV) victimization in women’s and men’s lives, yet many IPV service providers have not developed an integrated response to these issues. Fewer still have implemented substance use services from a harm reduction approach. This article outlines the approach, policy changes, initial outcomes, and learning points for an IPV agency in Ireland, which implemented a harm reduction response to female IPV survivors who were also using substances problematically. Barriers and challenges for staff and management seeking to coordinate and integrate service delivery on the dual issues are also presented.


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