A plea of those who are affected most by HIV: The utterances by women who inject Nyaope residing in the City of Tshwane Municipality, Gauteng

Background: Nyaope injecting practice brought the field of Human Immunodeficiency Virus (HIV) prevention and Substance Use Disorder (SUD) together. It is complex and requires multidisciplinary approach. Women who use drugs face individual, social, and structural factors that fuel their vulnerability to contract HIV, and other blood-borne infections. Women Who Inject Drugs (WWID) are a subpopulation that is neglected from HIV prevention and SUD treatment interventions, and are hardly the subject of surveys. In order to fully address the HIV epidemic among WWID it is imperative that they become part of the process of finding solutions.Aim: This study explored the strategies to curb HIV incidence among Women Who Inject Nyaope (WWIN), residing in City of Tshwane Municipality, Gauteng Province.Setting: The research was conducted within COSUP. COSUP was considered more appropriate as it is a harm reduction based organisation.Methods: The study utilised the qualitative research approach. Semi structured interviews were conducted with 24 women with a history of injecting Nyaope aged between 19 to 35 years. The data was analysed using thematic data analysis.Results: Health intervention, economic intervention and educational intervention was stressed as key strategies to curb HIV among WWIN. Needle exchange programmes, condom distribution, PrEP, HIV Testing and Counselling, employment opportunities, support groups and awareness campaigns if implemented, can yield positive outcomes in curbing HIV among WWID.Conclusion: Mechanisms to curb HIV among WWIN exist, and when implemented, they have the potential to address high HIV incidence among women who inject Nyaope.

Factors Influencing Medical Students' Attitudes Towards Substance Use During Pregnancy

Background: Many stigmas exist regarding people with substance use disorder especially among pregnant women, preventing optimal accessibility and quality of care. In this survey, we investigated attitudes of medical students regarding substance use during pregnancy and identified the factors that influence these attitudes. Methods: This cross-sectional study was conducted in 2019 and 2020 in Belgium using the short version of the "Substance Abuse Attitude Survey" questionnaire. We focused on two items regarding punishment of substance use during pregnancy. We analysed the concordance between these two, their correlation with other items (e.g stereotyping, morality, forced withdrawal, low treatment optimism) and the association between respondents’ agreement on punishment and their sociodemographic data. Results: The response rate was 65.2 % (370/567 online and face-to face questionnaires). 19.2% of respondents were in favour of punishment for alcohol use (n=353) and 15.1% for drug use (n=356) during pregnancy. The agreement analysis between the two items showed that14.3% of students were in favour of punishing both pregnant women who use drugs and those using alcohol. Respondents tended to be more in favour of punishment if they were male students, older, if they had a lower mother's education level or had no personal or family history of substance use. Attitudes appeared to be more punitive among students with limited contact with people with substance use disorder (i.e. none or limited to hospital). Students intending to specialise in internal medicine were more in favour of punishment of women whereas none of those intending to specialise in psychiatry were in favour. Conclusion: Our study shows that about 20% of surveyed medical students favoured punishing substance-using pregnant women. Awareness and training work seems to be necessary to ensure adequate care and support for this already vulnerable population.

QUALIFIED ASSISTANCE TO PREGNANT WOMEN IN USE OF ALCOHOL AND DRUGS

Objective: to analyze the nursing care provided to pregnant women who abuse alcohol and other drugs. Method: it is reported that seven nurses from the Psychosocial Care Center participated in the research to treat users of alcohol and other drugs. It is detailed that the collection occurred through the semi-structured interview, the organization of the data followed the technique of Content Analysis and the study was based on the Theory of Imogene King. Results: three themes were evidenced: Looking towards achieving harm reduction, Integrality of being and Nursing Process x integralization of assistance. Conclusion: it is concluded that, although assistance is based on harm reduction, the study demonstrated that there is a failure in the care of pregnant women who use drugs, considering that one of the principles of the Unified Health System, comprehensiveness, is still far away to be attended to, as the pregnant woman is assisted only on aspects of the use of alcohol and other drugs.

Social Stability and Unmet Health Care Needs in a Community-Based Sample of Women Who Use Drugs

Objective To examine the relationship between social stability and access to healthcare services among a community-based sample of adult female drug users. Methods We developed a measure of social stability and examined its relationship to health care access. Data came from a cross-sectional sample of female drug users (N = 538) in Oakland, CA who were interviewed between September 2014 and August 2015. We categorized women as having low (1-5), medium (6-10), or high (11-16) social stability based on the tertile of the index sample distribution. We then used ordered logistic regression to examine the relationship between social stability and self-reported access to mental health services and medical care. Results Compared with women in the low stability group, those with high stability experienced a 58% decline in the odds of needed but unmet mental health services [AOR: 0.42; 95% C.I.: 0.26, 0.69] and a 68% decline in the odds of unmet medical care [AOR: 0.32; 95% C.I.: 0.19, 0.54] after adjusting for confounders. The coefficients we observed reduced in size at higher levels of the stability index suggesting a positive association between social experiences and access to healthcare services. Conclusion Women who use drugs are at increased risk of adverse health outcomes and often experience high levels of unmet healthcare needs. Our study highlights the importance of addressing social determinants of health and suggests that improving social factors such as housing stability and personal safety may support access to healthcare among female drug users.