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Women Who Use Drugs and Have Sex with Women in a Canadian Setting: Barriers to Treatment Enrollment and Exposure to Violence and Homelessness

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Abstract

Individuals who use illicit drugs and belong to a sexual minority group often contend with elevated risks for adverse health outcomes. However, little is known about women who use drugs and have sex with women. We therefore sought to identify sociodemographic, substance use patterns, and exposures to social-structural factors associated with reporting sexual activity among women participating in three open prospective cohort studies of individuals who use illicit drugs in Vancouver, Canada. Generalized estimating equations were used to identify substance use patterns, violence, and other social and structural drivers of health-related harm among women who reported having sex with women (WSW) between December 2005 and May 2012. In multivariate analyses, younger age (adjusted odds ratio [AOR] 2.89; 95 % confidence interval [CI] 1.81, 4.60), violence (AOR 1.78; 95 % CI 1.22, 2.59), and homelessness (AOR 1.42; 95 % CI 1.00, 2.02) were associated with WSW. WSW were also less likely to report enrollment in addiction treatment (AOR 0.68; 95 % CI 0.46, 0.99). In a second model, sexual violence (AOR 3.47; 95 % CI 2.08, 5.78) in the previous 6 months was also found to be positively associated with WSW. These findings indicate a critical need for more thorough understandings of the intersections between sexual relationships, exposure to violence, and enrollment in addiction treatment among women who use illicit drugs, as well as the development of programs to address the unique needs of this population.

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Authors and Affiliations

  1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Tara Lyons, Kate Shannon, Lindsey Richardson, Annick Simo, Evan Wood & Thomas Kerr

  2. Department of Medicine, St. Paul’s Hospital, University of British Columbia, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada

    Tara Lyons, Kate Shannon, Evan Wood & Thomas Kerr

  3. School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, V6Z 1Y6, Canada

    Kate Shannon

  4. Department of Sociology, University of British Columbia, 6303 Northwest Marine Drive, Vancouver, BC, V6T 1Z1, Canada

    Lindsey Richardson

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  1. Tara Lyons
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  2. Kate Shannon
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  5. Evan Wood
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Correspondence to Thomas Kerr.

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Lyons, T., Shannon, K., Richardson, L. et al. Women Who Use Drugs and Have Sex with Women in a Canadian Setting: Barriers to Treatment Enrollment and Exposure to Violence and Homelessness. Arch Sex Behav 45, 1403–1410 (2016). https://doi.org/10.1007/s10508-015-0508-2

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  • DOI: https://doi.org/10.1007/s10508-015-0508-2

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