Intersecting motivations for leaving abusive relationships, substance abuse, and transactional sex among HIV high-risk women

Abstract

Background Women bear a significant burden of the HIV epidemic in the United States. Women classified as ‘HIV high-risk’ often bring co-existing histories of intimate partner violence (IPV), drug use, and transactional sex. To help inform future comprehensive HIV prevention strategies, we aimed to explore common motivating reasons and barriers to leaving and/or terminating engagement in each of these risk-promoting situations. Methods Between August and November 2014, in-depth interviews were conducted with 14 HIV high-risk women in Atlanta, Georgia who had experienced IPV in the previous 12 months, and used drugs and/or engaged in transactional sex in the previous five years. Participants were asked about histories of IPV, drug use, and/or engagement in transactional sex, and the motivating reasons and barriers to terminating each. Results Women reported a range of motivating reasons for leaving IPV, drug use, and transactional sex. Overlapping themes included impact on children, personal physical health/safety, and life dissatisfaction. Financial need was identified as a common barrier to leaving. Conclusions Future HIV prevention research should further explore the perceived impact of IPV, drug use, and transactional sex on physical health/safety, life dissatisfaction, one’s children, and financial need as motivators and barriers to reducing upstream HIV risk.

Transactional sex among rural, justice‐involved Appalachian women who use drugs

“…Regression results provided further evidence of the relationships between transactional sex, drug use, and socioeconomic status. 2,4,5,13,15 In this study, being incarcerated on a property offense (eg, theft) and greater substance use problem severity were associated with an increased likelihood of transactional sex. In a region characterized by widespread poverty, limited employment opportunities, and high rates of substance use, 27,28 incarceration may lead to an even greater economic burden given women's multiple, intersecting disadvantages.…”

Vulnerability Elements for Permanence in Marital Violence: Speeches of Women Who Consume Alcohol/Drugs

“…National studies conducted in Vitória and João Pessoa revealed that financial dependence, coupled with low schooling and concern with self-support and support of the children, represents an unfavorable scenario for seeking help and, consequently, it is conducive to the permanence of women in the situation of marital violence, not being a specific element for women who use drugs [19][20][21] . Financial subjection to the spouse as an element of vulnerability to living and staying in marital violence has also been identified in studies conducted in the United States, Ethiopia, Nigeria and Kenya [22][23][24][25] .…”

Elementos De Vulnerabilidade Para Permanência Na Violência Conjugal: Discurso De Mulheres Que Consomem Álcool/Drogas

“…Estudos nacionais realizados em Vitória e João Pessoa revelaram que a dependência financeira, atrelada à baixa escolaridade e à preocupação com o autossustento e o sustento dos filhos, representa cenário desfavorável para a busca de ajuda e, consequentemente, propício para a permanência das mulheres na situação de violência conjugal, não sendo elemento específico para mulheres que consomem drogas [19][20][21] . A sujeição financeira ao cônjuge enquanto elemento de vulnerabilidade para vivência e permanência na violência conjugal foi também identificada em estudos realizados nos Estados Unidos, Etiópia, Nigéria e Quênia [22][23][24][25] .…”