Surviving in two worlds: Social and structural violence of Thai female injecting drug users

Haritavorn, Niphattra

doi:10.1016/j.drugpo.2013.09.008

Cited by 21 publications

(14 citation statements)

References 24 publications

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“…For females, assisted injecting is often a feature of intimate or romantic relationships where male partners commonly control the drugs to be injected [ 14 , 20 ]. This has been argued to further subordinate women within drug scenes and increasing their vulnerability to negative health consequences such as blood-borne infections [ 11 , 24 , 25 ]. Thus, we recommend that future interventions examine ways of addressing the gender disparity in rates of assisting injecting, including consideration of the social and structural context.…”

Section: Discussionmentioning

confidence: 99%

Declining trends in the rates of assisted injecting: a prospective cohort study

et al. 2016

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BackgroundAssisted injecting has been associated with increased risk of blood-borne infections, overdose, and other harms among people who inject drugs (PWID), particularly women. Given the changing availability of relevant harm reduction interventions in Vancouver, Canada, in recent years, we conducted a gender-based analysis to examine changes in rates and correlates of assisted injecting over time among active PWID.MethodsUsing data from a prospective cohort of PWID in Vancouver, we employed gender-stratified multivariable generalized estimating equations to examine trends in assisted injecting and identify the correlates during two periods: June 2006–November 2009 and December 2009–May 2014.ResultsAmong 1119 participants, 376 (33.6 %) were females. Rates of assisted injecting declined between 2006 and 2014 among males (21.9 to 13.8 %) and females (37.0 to 25.6 %). In multivariable analyses, calendar year of interview also remained independently and negatively associated with assisted injecting among males (adjusted odds ratio [AOR] 0.95, 95 % confidence interval [CI] 0.92–0.99) and females (AOR 0.93, 95 % CI 0.89–0.97). Syringe borrowing remained independently associated with assisted injecting throughout the study period among females (AOR 1.53, 95 % CI 1.10–2.11 during 2006–2009; AOR 2.15, 95 % CI 1.24–3.74 during 2009–2014) and during 2009–2014 among males (AOR 1.88, 95 % CI 1.02–3.48).ConclusionsOur findings demonstrate assisted injecting has significantly decreased for both males and females over the past decade. Nevertheless, rates of assisted injecting remain high, especially among women, and are associated with high-risk behavior, indicating a need to provide safer assisted injecting services to these vulnerable sub-populations of PWID.

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Section: Discussionmentioning

confidence: 99%

Declining trends in the rates of assisted injecting: a prospective cohort study

et al. 2016

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“…The drug‐taking milieu poses continual challenges that make it almost impossible to sustain an identity as a good mother. The women are caught between the masculine‐dominated world of drug use and taken‐for‐granted lifeworld ideas about motherhood (Haritavorn ). Much activity surrounding the drug subculture operates in an overtly masculine culture, with lying, deceit and violence a part of everyday life (Briggs , Singer ).…”

Section: Discussionmentioning

confidence: 99%

“…Much activity surrounding the drug subculture operates in an overtly masculine culture, with lying, deceit and violence a part of everyday life (Briggs , Singer ). Living in drug community, Thai women injecting drugs encounter everyday violence which is embedded in the drug subculture (Haritavorn ). The drug subculture brings physical risks to children and stigma that demarcates mother using drugs from ‘good’ motherhood.…”

Section: Discussionmentioning

confidence: 99%

I am just a ‘maae’ (mother): experiences of mothers injecting drugs in Thailand

Haritavorn

2016

Sociology Health & Illness

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Mothers who use drugs face much discriminatory action as society in general finds female drug users' modes of caring for their children unacceptable. In this article, I explore the ways in which Thai women's injecting practices revolve around the role of mother 'maae' and the ways they employ tactics to challenge the motherhood discourse. This article draws on in-depth interviews with 30 Thai mothers injecting drugs. Thai mothers injecting drugs struggled with stigma and self-blame. They internalise the values of the mother 'maae', that is, what the mother is supposed to be; attempting to combine their drug use with their parental responsibilities. Having a child is treated as a means for many women to manage the hostile social impacts of being an addict mother as well as anxieties about the future of their children. To maintain identity as a mother, as gender norms dictates, the mothers employ several tactics to defend that identity from the threats. In conclusion, the findings have implications for harm reduction and reproductive services for women using drugs in Thailand; health care providers need to appreciate the ramifications of the lived experiences of the women who take drugs.

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“…It was the seventh largest contributor to the years lived with disability for 354 diseases and injuries globally in 2017 for men, and the 18th largest contributor for women (GBD 2017 Disease and Injury Incidence and Prevalence Collaborators, 2018). Drug use disorders can have many adverse social, psychological and physical consequences (Haritavorn, 2014; Nogueira et al , 2014; Compton et al , 2019), including damage to major life roles, high suicide risk, neuropsychological deficits, decreased quality of life, high rates of risky behaviours (e.g. unsafe sex and drug injection), and increased risk of infectious diseases (e.g.…”

Section: Introductionmentioning

confidence: 99%

Trends of the incidence of drug use disorders from 1990 to 2017: an analysis based on the Global Burden of Disease 2017 data

Pan

Zhang

Cheng

et al. 2020

Epidemiol Psychiatr Sci

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Aim Drug use disorders are an important issue worldwide. Systematic attempts to estimate the global incidence of drug use disorders are rare. We aimed to determine the incidence of drug use disorders and their trends. Methods We obtained the annual incident cases and age-standardised incidence rate (ASR) of drug use disorders from 1990 to 2017 using the Global Health Data Exchange query tool. The estimated annual percentage changes of the ASR were used to quantify and evaluate the trends in the incidence rate. Gaussian process regression and the Pearson's correlation coefficient were used to assess the relationship between the ASR and socio-demographic index (SDI). Results The number of drug use disorders’ cases increased by 33.5% from 1990 to 2017 globally, whereas the ASR exhibited a stable trend. The ASR was higher in men than in women. Most cases (53.1%) of drug use disorders involved opioid. A positive association (ρ=0.35, p < 0.001) was found between ASR and SDI. Teenagers aged 15–19 years had the highest incidence rate. Conclusions The incident cases of drug use disorders were increasing, but the incidence rate did not change significantly from 1990 to 2017. Current preventive measures and policies for drug use disorders might have little effect. The present results suggest that future strategies should focus on men, teenagers and high-risk regions in order to improve the current status of drug use disorders.

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Surviving in two worlds: Social and structural violence of Thai female injecting drug users

Cited by 21 publications

References 24 publications

Declining trends in the rates of assisted injecting: a prospective cohort study

Declining trends in the rates of assisted injecting: a prospective cohort study

I am just a ‘maae’ (mother): experiences of mothers injecting drugs in Thailand

Trends of the incidence of drug use disorders from 1990 to 2017: an analysis based on the Global Burden of Disease 2017 data

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