Linking drug-related activities with experiences of partner violence: a focus group study of women in methadone treatment.

This study examines various contexts in which drug-related activities may be linked with intimate partner violence among women in methadone treatment. We conducted 14 focus groups with 68 predominantly Latina and African American women, who reported recent partner abuse. Guided by Goldstein's tripartite model, gender theory, and trauma theory, our inquiry explored how partner violence may be related to psychopharmacological effects of drug use and to conflicts over procuring and splitting drugs. We also examined whether women used drugs to cope with the violence. Across the focus groups, women reported that their low social status and perceived sexual availability as "drug-using women," their partner's substance use, their own verbal aggression under the influence of crack and alcohol, and conflicts over procuring and splitting drugs played a role in their victimization. The findings further suggest that conflicts over gender role expectations interact with drug-related activities, increasing the likelihood of a violent outcome.

The converging epidemics of mood-altering-drug use, HIV, HCV, and partner violence: a conundrum for methadone maintenance treatment.

BACKGROUND: Accumulating evidence suggests that partner violence may be associated with HIV risk behavior and drug use among women in methadone maintenance treatment programs (MMTPs), yet the mechanisms linking these overlapping problems remain unclear. The main purpose of this qualitative study is to explore in detail how drug-related activities and HIV risk behavior occur in the context of a recent episode of partner violence among women in MMTPs. METHOD: We conducted and analyzed in-depth interviews with 31 women who reported having experienced physical or sexual violence by an intimate partner during the past year. Guided by existing research, feminist theory and trauma theory, we constructed a set of questions which were designed to explore multiple ways in which drug-related activities or HIV risk behavior may be linked directly or indirectly to the recent event. To examine the extent and significance of the woman sand/or her partner s drug-related activities or sexual HIV risk issues occurring immediately before, during and/or after the most recent event, we adapted a series of techniques for thematic analysis of qualitative data. RESULTS: Of the 31 women who reported recent events: 83.8 % (n=26) recalled recent events in which there was some drug-involvement; 40% (n=13) indicated that both she and her partner were involved in drug-related activities during the most recent event of partner abuse; 35% (n=11) reported that the partner was drug-involved; and only two women (6.4%) indicated that they alone had been drug-involved. One-fifth (19.3%, n=6) of the women indicated that they had used drugs immediately after the event because they were upset or in physical pain. One-fifth of the women (n=6) reported that they had coerced, unprotected sex during or after the most recent incident. CONCLUSIONS: The multiple ways in which the use of mood-altering drugs are related to partner violence and the occurrence of coerced, unprotected sex underscore the need to design specific interventions for preventing drug relapse, and HIV and HCV infection among abused women in MMTPs. Treatment and policy implications of study findings are discussed.

Fear and violence: raising the HIV stakes.

Through focus group methodology, the study examines three contexts that delineate the co-occurrence of intimate partner violence and sexual risk behaviors among 68 women on methadone. First, it explores the ways in which the presence of physical abuse in an intimate relationship prevents women from asking their partners to use a condom. Second, it describes the ways in which the couple's drug involvement increases the risk of physical and sexual violence, and concomitant sexual HIV risks. Third, it discusses the context in which sexual assault and rape occur in these established intimate relationships and how these abusive events increase women's risks of becoming infected with HIV. The research is guided by feminist theory, which affords powerful insight into the contexts in which women are put at risk for HIV and partner violence. The study provides a discussion on the implications of the findings to HIV prevention for women who are risk for both HIV and partner violence.