Sexual Violence in the Context of Drug Use Among Young Adult Opioid Users in New York City

Abstract

Drug and alcohol use have been associated with increased risk for sexual violence, but there is little research on sexual violence within the context of drug use among young adult opioid users. The current mixed-methods study explores young adult opioid users’ sexual experiences in the context of their drug use. Forty-six New York City young adults (ages 18–32) who reported lifetime nonmedical use of prescription opioids (POs) completed in-depth, semistructured interviews, and 164 (ages 18–29) who reported heroin and/or nonmedical PO use in the past 30 days completed structured assessments that inquired about their drug use and sexual behavior and included questions specific to sexual violence. Participants reported frequent incidents of sexual violence experienced both personally and by their opioid using peers. Participants described sexual violence, including sexual assault, as occurring within a context characterized by victimization of users who were unconscious as a result of substance use, implicit and explicit exchanges of sex for drugs and/or money that increased risk for sexual violence, negative sexual perceptions ascribed to drug users, and participants’ own internalized stigma. Recommendations to reduce sexual violence among young adult opioid users include education for users and service providers on the risk of involvement in sexual violence within drug using contexts and efforts to challenge perceptions of acceptability regarding sexual violence.

Alcohol, Prescription Drug Misuse, Sexual Violence, and Dating Violence Among High School Youth

“…Emerging research among young adults has pointed to prescription opioid misuse as a potential risk factor for SV victimization, as the victim may be incapacitated at the time of victimization or exchanging drugs for sex which increases SV risk [21]. For TDV, Parker et al used cross-sectional latent class analysis (LCA) to classify adolescents based on their alcohol, tobacco, marijuana, and prescription drug use [13].…”

Sexual Risk and Transmission Behaviors, Partnerships and Settings Among Young Adult Nonmedical Opioid Users in New York City

“…The different time periods covered by sexual and drug use variables limit the conclusions that can be reached from their associations. In addition, an earlier paper by this project reported that some men have sex with women or MSM opioid users when they are semi-conscious or unconscious due to the effects of drugs (30). This could lead to under-reporting of partnerships and other sexual risks by these unwitting partners.…”

Alternate Routes of Administration among Prescription Opioid Misusers and Associations with Sexual HIV Transmission Risk Behaviors

“…Sexual victimization history, another HIV transmission risk factor, was also associated with alternate routes of administration. These risk factors may be exacerbated when combined with other behaviors associated with prescription opioid misuse, including risky injection practices and sex while high (Mateu-Gelabert et al 2015, Jessell et al 2015, Meade et al 2014). …”

“…The misuse of prescription opioids among young people is associated with several health and social problems, including mental distress, victimization, and homelessness (Schrager et al 2014, Mackesy-Amiti, Donenberg, and Ouellet 2015, Jessell et al 2015). The use of alternate routes of administration of prescription opioids, including snorting, smoking, or injecting, may result in increased vulnerability, as the effects of the drug are intensified and the risk of addiction is elevated (Compton and Volkow 2006).…”

“…Emerging data suggest that prescription opioid misusers, including those who report alternate routes of administration of opioids, are engaging in sexual risk behavior, including condomless vaginal and anal sex and group sex (Mateu-Gelabert et al 2015, Buttram and Kurtz 2015, Johnson et al 2013). In addition, in-depth research conducted among young adult prescription opioid misusers shows that both men and women report a variety of sexual behaviors and risks, including increased sexual encounters, implicit and explicit exchanges of drugs and sex, sexual victimization, and casual sex with other prescription opioid misusers (Johnson et al 2013, Mateu-Gelabert et al 2015, Jessell et al 2015). …”