Vulnerability, Risk and Harm for People Who Use Drugs and Are Engaged in Transactional Sex: Learning for Service Delivery

Abstract

Against a backdrop of high levels of drug related harms in Scotland, this research aimed to inform training development to aid the upskilling of the workforce to support people who use drugs and are involved in transactional sex. Sixteen qualitative interviews were conducted with participants recruited across four health board areas and a range of services covering sexual health and/or harm reduction. Interviews explored initiation, frequency, and the nature of transactional sex; drug use, and experience of services. A thematic analysis was undertaken. Vulnerability was a key emerging theme when discussing drug use, sexual behavior, and service use. Vulnerability increased risk of a range of harms from sexual assault to injecting harms and overdose. Participants were often, but not always, introduced to drugs and transactional sex by someone who had power over them or was more experienced in drug use and/or sex. High risk drug use was evident in terms of polydrug use, consuming large quantities of drugs, sharing crack pipes/injecting equipment. There is a need for information and services to reduce the risk of harm from drugs, sexual violence, and unprotected sex as well as non-judgmental, trauma aware services. The workforce needs to be skilled to recognize and manage these potentially complex syndemics.

Factors Associated with Changes in E-Cigarette Use and Tobacco Smoking by Adolescents and Young People in Nigeria during the COVID-19 Pandemic

“…These variables are associated with the dependent and independent variables [29]. The participants were also asked to select the appropriate age group (categorized into 11-17 and 18-23 years), sex at birth (male, female) and vulnerability status (engaged in transactional sex, used illegal/prescription drugs without prescription and injected drugs [30]).…”

A multi-country survey on access to healthcare and treatment services among individuals with critical medical care needs during the first wave of the pandemic

“…Populations whose access to healthcare must have also been disrupted during the pandemic are those who need a lot more hospital facility-based care such as females [11], people with lower educational status [12], elderlies [13] and populations that are macro-socially vulnerable like transactional sex workers and people who use drugs [14]. These are socio-economically disadvantaged populations who are also worse affected by the COVID-19 pandemic [15,16].…”