First Report of Gender Based Violence as a Deterrent to Methadone Access Among Females Who Use Heroin in Dar es Salaam, Tanzania.

Journal: AIDS and behavior

Volume: 21

Issue: 7

Year of Publication: 2018

Affiliated Institutions:  Yale University, Columbus Avenue, New Haven, CT, , USA. Department of Community and Global Health, The University of Tokyo, Tokyo, Japan. Pangaea Global AIDS Foundation, Oakland, CA, USA. Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. Centers for Disease Control and Prevention, Dar es Salaam, Tanzania. Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA. Yale University, Columbus Avenue, New Haven, CT, , USA. dbruce@cornellscott.org.

Abstract summary 

High prevalence of human immunodeficiency virus (HIV) among females who use drugs in Dar es Salaam, Tanzania, contrasts strikingly with their low enrollment in HIV risk reduction services such as methadone assisted therapy (MAT). We conducted a case-control study to examine factors associated with non-enrollment in MAT, with a focus on gender-based violence. We interviewed 202 female heroin users not enrolled in MAT as cases and 93 females enrolled in MAT. We fitted logistic regression models with MAT enrollment as the outcome of interest. The likelihood of MAT enrollment decreased upon being in a violent relationship [odds ratio (OR) 0.23; 95 % CI 0.11-0.40], with experience of discrimination by a healthcare provider (OR 0.11; 95 % CI 0.04-0.35), and having a partner who also uses drugs (OR 0.05; 95 % CI 0.01-0.26). The results indicate that violence and discrimination are major impediments to MAT enrollment, necessitating implementation of interventions to address them.

Authors & Co-authors:  Balaji Divya D Mlunde Linda B LB Tran Olivia C OC Lambdin Barrot B Mbwambo Jessie J Nyandindi Cassian C Matiko Eva E Copenhaver Michael M Douglas Bruce R R

Study Outcome 

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Statistics
Citations : 
Authors :  9
Identifiers
Doi : 10.1007/s10461-016-1529-0
SSN : 1573-3254
Study Population
Female,Females
Mesh Terms
Adolescent
Other Terms
Female drug users;Gender-based violence;HIV;Heroin;Methadone
Study Design
Case Control Trial
Study Approach
Country of Study
Tanzania
Publication Country
United States