325580
Why homeless and unstably housed women initiate stimulant use in mid-life
methods: Between June 2008 and August 2010, biological women were systematically sampled from San Francisco homeless shelters, free meal programs and low-income hotels. The relative risk of stimulant use (crack cocaine, powder cocaine or methamphetamine) during the first six months of follow-up was estimated.
results: Among 260 women, the median age was 47, 70% were women of color and 47% reported having recent unmet subsistence needs. Abstinence from stimulants at baseline was reported by 118 participants (53%). Adjusting for baseline sociodemographics and drug treatment, the risk of initiating stimulant use among women who did not use at baseline was significantly higher among those who reported recent sexual violence (Adjusted Relative Risk [ARR]= 4.31; 95% CI:1.97-9.45) and sleeping in a shelter or public place (ARR=2.75; 95% CI:1.15-6.57).
conclusion: Almost half of HUH women used stimulants at baseline, and 14% of those who did not, initiated use within 6 months. Substance use treatment may have a significant impact, but by itself insufficiently addresses impoverished women’s vulnerability to factors that increase the risk of stimulant use such as sexual violence and homelessness. Addressing upstream risk factors by preventing homelessness and sexual violence is critical to reduce stimulant use among impoverished women.
Learning Areas:
Diversity and cultureEpidemiology
Program planning
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health
Learning Objectives:
Identify risk factors for initiating stimulant use among homeless and unstably housed women who do not use at baseline
Determine whether drug treatment participation mediates risks identified
Discuss the implications of study findings on population-level services aimed at reducing drug use and improving health among impoverished women
Keyword(s): Women's Health, Drug Abuse Prevention and Safety
Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally funded grants focusing on the epidemiology of drug use, HIV prevention and health disparities. Among my scientific interests has been the development of strategies for improving health and access to health services among homeless and unstably housed women.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.