HEALTHCARE SERVICE ACCESS, SEXUAL AGGRESSION EXPERIENCES, AND HIV-RELATED RISK BEHAVIORS AMONG PUERTO RICAN FEMALE INTRAVENOUS DRUG USERS

Abstract

Female Intravenous Drug Users (IDUs) face numerous unique health risks and challenges, yet their singular experiences are rarely captured in research given how difficult these populations can be to reach. The purpose of this study was to gain a better understanding of the HIV-related sexual and drug use behaviors of, and to assess the experiences of access to healthcare services and of sexual aggression among female IDUs in Puerto Rico. In collaboration with community based and government organizations that provide drug outreach programs and addiction treatment services in Puerto Rico, a mixed-methods study, utilizing a transformative theoretical perspective, was completed utilizing surveys and semi-structured interviews as methods of inquiry. Ninety women who reported IDU within the last 12 months and who received services from one of the study recruitment venues were recruited to participate in the survey portion of the study. Additionally, 35 women who had previously completed the survey completed semi-structured interviews. Measures included sociodemographic characteristics, drug use, most recent/lifetime sexual behavior history, experiences of sexual violence, and access to and utilization of healthcare services, in addition to experiences seeking sexual health information. Data presented in this dissertation are explored in two manuscripts that address: 1) what sexual and drug use behaviors are most prevalent in this population; and 2) what Puerto Rican female IDU's experiences are when seeking healthcare services and sexual health information, and what barriers are present for them in doing so. Findings provide a number of implications and considerations for future research and programs targeting female IDUs in Puerto Rico. Results suggest the need for a variety of services, including educational sexual health promotion interventions with a particular focus on how to access sexual health information and sexual violence counseling, as well as the inclusion of prevention interventions as part of existing drug treatment programs. Additionally, interventions that facilitate access and utilization of healthcare services, as well as measures to reduce stigma towards female IDUs on the island, should be explored.