Boyfriends and injecting: the role of intimate male partners in the life of women who inject drugs in Central Java

Abstract

The international literature shows that HIV-risk behaviour for women mostly occurs in the context of intimate relationships. Power imbalances in the social, economic and cultural spheres put women at risk. This paper addresses the roles of male partners in women's engagement in drug-use behaviour and drug-related HIV-risk behaviour in Indonesia. Data were gathered through in-depth interviews with 19 women who had injected drugs in the previous month in three sites in central Java. Most of the women had male partners who also injected drugs. Results show that male partners play a significant role in the initiation of drug use, the provision of drugs, injecting behaviour and in the constitution of women injectors' social networks. These findings suggest the need to develop couple-based interventions and to facilitate women-only groups as part of HIV prevention.

HIV risks among injecting and non-injecting female partners of men who inject drugs in Almaty, Kazakhstan: Implications for HIV prevention, research, and policy

“…The majority of FWID inject with their main partners and engage in unsafe injection behaviors with their partners. This supports other literature on injection drug use in intimate relationships which has found that FWID share drug equipment and engage in risky injections with their male partners (El-Bassel et al, 2013; Lazuardi et al, 2012; Seear et al, 2012; Simmons et al, 2012; Wagner et al, 2013). The most common unsafe behaviors were (1) drawing a drug solution from a vessel shared with others and (2) preparing drugs with another person and then splitting the solution.…”

“…Using the same syringes and drug equipment after their partners raises the female partner’s risk for HIV and HCV infection (Lazuardi et al, 2012; Wagner, Jackson Bloom, Hathazi, Sanders, & Lankenau, 2013). However, by refusing to share syringes or drug equipment FWID may increase their risk of physical and sexual intimate partner violence (IPV) (El-Bassel et al, 2011; 2010).…”

The experience of initiating injection drug use and its social context: a qualitative systematic review and thematic synthesis

“…Friends (41, 44, 47, 48, 50, 51, 55, 56, 60, 68, 70, 73, 77), family (41, 43, 44, 51, 52, 55, 68, 70–73), intimate partners (42, 48, 49, 52, 57, 59, 60, 64, 68, 70–72, 77), acquaintances (37, 43, 77), gang members (63), elders (65) and drug dealers (41, 42) were all described as influential. Different types of social interactions shaped injection initiation.…”

Illicit drugs in Central Asia: What we know, what we don’t know, and what we need to know

“…Because of the vulnerabilities described above and, in particular, stigma and discrimination, FWID may access health services at later stages of deteriorating health. These issues are further complicated by the fact that FWID face greater challenges than MWID in obtaining sterile injection equipment and accessing harm reduction programmes (Des Jarlais, Feelemyer, Modi, Arasteh, & Hagan, 2012), due to a reliance on intimate partners to provide drug-using resources including needles (Lazuardi et al, 2012) and greater levels of discrimination experienced when seeking HIV and drug use treatment as well as a lack of female-specific services (El-Bassel et al, 2010, 2014a. Each of these factors may play a role in the gender disparities in mortality rates found in the Mravcik et al (2014) study.…”