Drug Use, Hepatitis C, and Service Availability: Perspectives of Incarcerated Rural Women

Abstract

This study examined drug use, hepatitis C, and service availability and use among a high-risk sample of rural women serving time in jails. Data was collected from female offenders (n=22) who participated in four focus groups in three rural jail facilities located in Appalachia. Findings indicated that drug misuse is prevalent in this impoverished area of the country, and that the primary route of administration of drug use is injection. Findings also indicate that injection drug use is also commonly associated with contracting hepatitis C (HCV), which is also perceived to be prevalent in the area. Despite knowledge associated with HCV risks, women in this sample were seemingly apathetic about the increasing spread of HCV in the area and unconcerned about the long-term consequences of the course of the infection. Implications for future research and practice are discussed.

Barriers to Access and Adoption of Pre-Exposure Prophylaxis for the Prevention of HIV Among Men Who Have Sex With Men (MSM) in a Relatively Rural State

“…Geographic isolation limits access to health services that support sexual health for MSM residing in relatively rural areas (Williams, Bowen, & Horvath, 2005). Emergent research has documented barriers to sexual health care within these areas (Hubach et al, 2015;Pellowski, 2013;Reif, Golin, & Smith, 2005;Staton-Tindall, Webster, Oser, Havens, & Leukefeld, 2015), yet little is known about the scope of sexual health care available to them in relation to PrEP access and adoption. The nascent literature on MSM residing in relatively rural states, outside of the Deep South, have found that MSM have difficulty identifying prevention programs or local testing sites, do not believe that HIV and STIs are a local threat, and do not engage in HIV and STI risk reduction (Kelly, 1994;Williams et al, 2005).…”

Health Services Use Among Jailed Women with Alcohol Use Disorders

“…49 This finding is also unexpected in light of interviews with jailed women that revealed high rates of hepatitis C (HCV) and of HCV and HIV risk behaviors among those using drugs. 50–51 A lower overall quality of medical care has been found among patients with illicit drug use, 52 which may discourage use of medical services, especially by those already receiving specialty substance use care. Suboptimal health care for persons using drugs may be explained by health professionals’ negative attitudes toward these patients, as shown by a systematic review and surveys assessing stigma in this context.…”

HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs

“…The opioid epidemic is also associated with increased rates of injection drug use (IDU) in rural areas of Appalachian, particularly in Kentucky (2), as well as alarming trends in infectious disease transmission [such as Hepatitis C (HCV)] (3, 4, 5, 6). In fact, Kentucky (KY) had the highest proportionate rate of new HCV infections in the nation from 2008–2015 (3) and an overall prevalence rate nearly seven times higher than the national average (6).…”

“…These risks are further complicated by apathy about contracting infectious diseases among rural women who use drugs. This apathy is illustrated by comments describing HCV as “common as a bad cold around here” and “it’s really not that big of a deal, everybody’s got it” (5). These factors bolster the need for targeted HIV risk-reduction interventions among rural Appalachian women.…”