Structural Interventions for HIV Prevention Among Women Who Use Drugs: A Global Perspective
Structural Interventions for HIV Prevention Among Women Who Use Drugs: A Global Perspective
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DOI：
10.1097/qai.0000000000000638
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发表时间：
2015-06-01
影响因子：
3.6
通讯作者：
El-Bassel, Nabila
中科院分区：
文献类型：
--
作者：
Blankenship, Kim M.;Reinhard, Erica;El-Bassel, Nabila
我们简要回顾了关于吸毒者艾滋病毒风险的背景来源--吸毒者风险环境--以及解决吸毒者易感染艾滋病毒的结构性干预措施的现有文献。我们认为，性别不平等和性别权力关系的问题在很大程度上没有出现在这部文献中。然后，我们确定了五个背景因素，这些因素对于了解妇女的艾滋病毒相关脆弱性至关重要，而且其影响在吸毒妇女中加剧，包括生殖劳动分工，妇女对家庭照顾负有主要责任，妇女缺乏充分获得或控制生产资源和决策的机会，妇女易受性暴力和身体暴力的伤害，特别是亲密伴侣暴力，妇女(特别是异性恋妇女)对关系的依赖和在性行为中的有限权力，以及加强这些其他因素的有害的性别规范。我们讨论了一系列结构性干预措施和结构性干预方法，有可能解决这些背景因素，并呼吁进行更多研究，以更好地了解吸毒妇女的风险环境以及结构性干预措施对其的影响。我们认为，如果我们不充分纳入对两性不平等和按性别划分的权力关系的分析，我们对吸毒者艾滋病毒相关风险环境的了解和影响的能力是不完整的。
We briefly review extant literature on the contextual sources of HIV risk among drug users-the drug user risk environment-and on structural interventions to address drug user vulnerability to HIV. We argue that issues of gender inequality and gendered power relations are largely absent from this literature. We then identify 5 contextual factors that are critical for understanding women's HIV-related vulnerability and whose impacts are exacerbated among women who use drugs, including a division of reproductive labor in which women bear primary responsibility for family caretaking, women's lack of full access to or control of productive resources and decision making, women's vulnerability to sexual and physical violence, and especially, intimate partner violence, women's (particularly heterosexual women's) relationship dependency and limited power in sexual interactions, and harmful gender norms that reinforce these other factors. We discuss a range of structural interventions and structural intervention approaches with the potential to address these contextual factors and call for more research, both to better understand the risk environment of women who use drugs and the impacts of structural interventions on it. We argue that our understanding of and ability to impact on the HIV-related risk environment of drug users is incomplete if we do not fully incorporate the analysis of gender inequality and gendered power relations.