Discrimination is associated with both mental and physical health, and may be a particularly important determinant of health among marginalized groups. This study assessed differences in ...discrimination experiences and responses to discrimination between Black and Latino active substance users in New York City.
500 Black and 419 Latino active substance users were recruited through outreach workers, service agencies, and word of mouth. We collected data about different types of discrimination experienced (eg, discrimination due to race, gender, substance use), the domains in which it occurred (eg, at work, with police), and participants' responses to unfair treatment.
Discrimination due to drug use was the most commonly reported type of discrimination among both Blacks and Latinos. Black respondents were more likely than Latinos to report discrimination due to their drug use (79% to 70%), race (39% to 23%), poverty (38% to 26%), gender (18% to 9%), and sexual orientation (38% to 6%). However, among those reporting discrimination due to drug use, Latinos experienced more rejection from family (81% to 70%), friends (73% to 60%), police (86% to 79%), employers (72% to 56%), and medical care professionals (29% to 18%). Black respondents were more likely to respond actively to discrimination, whereas Latino respondents were more likely to internalize experiences.
Substantial differences exist in discrimination experiences and responses to discrimination between Black and Latino substance users. These differences may help explain racial and ethnic differences in health among marginalized populations, and identify avenues for effective, targeted intervention.
to describe midwives’ perceptions of the early mothering experiences of 20 Australian illicit-drug-using mothers.
a qualitative retrospective study using an explorative descriptive design. Twenty ...client records, completed by research midwives over 6 months (with follow-up visits at 12 and 18 months), formed the data set. Thematic analysis and the techniques associated with constant comparison were used to analyse the data.
Perth, Western Australia.
twenty postpartum women with a history of using illicit drugs.
seven major themes were identified that described how childbearing women with drug problems strive to be ‘normal mums’ although living on the fringe of society. The first three major themes were labelled;
Baby as the priority;
Hating the body: and
Life sucks. Theme four represents the level of family and community support available, which had the potential to facilitate and/or hinder the experience. The analysis suggested that women who had good support, particularly at 4 months postpartum and beyond, were more likely to move towards the fifth theme
Hanging in there: striving to be a normal mum. Women with minimal support, living in hostile and often abusive environments, gravitated towards the theme of
Beyond caring with the eventual consequence being chaos and a return to heavy drug use, labelled
Emotional fibrillation.
very few women were using drugs early in the postnatal period. These new mothers made every effort to prioritise the needs of their newborns, often within a context of abusive relationships, poor emotional well-being and financial hardship. High levels of physical and psychological morbidity were related to psychosocial factors as opposed to drug use alone. By 4 months postpartum, there was evidence that women were becoming increasingly vulnerable to the challenges of their lives. Family and community support played a role in how this group of women moved through their mothering experience.
the range of health, social and support services required by new mothers when they are using illicit drugs is substantial. Collaboration and coordination between agencies is crucial for quality outcomes. Fostering positive relationships with drug-using pregnant women and maintaining these links into the extended postnatal period may be one strategy that would improve the integration of services and ensure that women stay engaged with the system.
Alcohol, substance and drug use among urban slum adolescents is not only a risky behavior in the era of HIV/AIDS but also a potential security threat to a growing city. Based on the Nairobi Urban ...Slum Survey, adolescent males are more than 20 times more likely to engage in drugs, and 5 times more likely to consume alcohol than girls. In addition, being out-of-school increases the risk of alcohol and drug abuse. There is a gender dimension to this; societal expectation, division of labor, and nature of upbringing is different for males and females. While the government policy of free primary education is likely to reduce the alcohol and drug incidence, gender targeted interventions, providing alternatives for both boys and girls, would be equally essential.
We assessed the prevalence of HIV and selected blood-borne and sexually transmitted infections among a convenience sample of 64 residents of Dzsumbuj, a predominantly Roma (Gypsy) neighbourhood in ...Budapest, Hungary. No cases of HIV were detected, while the prevalence of hepatitis B infection (anti-HBc) was 27% and syphilis prevalence was 2%. Romas (n = 50) were significantly more likely than non-Romas (n = 14) to have HAV antibodies (80% vs. 43%) and less likely to be HBV immunized (anti-HBs only; 6% vs. 29%). Current drug injectors (n = 13) were more likely than non-injectors (n = 51) to have antibodies against HAV (85% vs. 69%) and HCV (85% vs. 8%). While HIV has not been introduced in this population, risk conditions for a potentially explosive HIV epidemic are present. Health care policies should focus on expanding coverage for HAV and HBV immunizations, and access to HIV preventive services needs to be extended to marginalized, mostly minority populations, such as the Roma in Europe.
To examine the extent to which personality and peer factors mediate the relationship between early cigarette use and later illicit drug use, as well as associated drug use problems, in a population ...of Colombian adolescents.
A longitudinal study (2-year interval), using face-to-face structured interviews was begun in 1996 using a community-based sample, randomly selected from census data in three cities in Colombia, South America. The participants were 2837 adolescents with a mean age of 15.0 (SD ± 1.6) years at time 1 (T1). Males comprised 52% of the sample and 65% resided with two parents. Approximately 78% (N = 2226) completed the second structured interview 2 years later (T2). The main outcome measures were marijuana use, other illicit drug use, and associated drug use problems at T2. Three series of logistic regressions were conducted.
The odds of marijuana use (adjusted odds ratio AOR = 1.64–2.01; confidence interval CI: 1.11–2.94), other illicit drug use (AOR = 1.77–2.49; CI: 1.03–4.19), and associated drug use problems (AOR = 2.25–3.47; CI: 1.45–5.26) at T2, was increased two- to three-fold among adolescents reporting cigarette use at T1, with control on the demographic, personality, and peer factors, as well as T1 drug use variables.
Earlier adolescent cigarette smoking was directly associated with later marijuana use, other illicit drug use, and problems with drug use.
The aim of the present investigation was to study the prevalence of psychiatric disorders in a sample of delinquent adolescents of both genders and to compare the prevalence between genders. A total ...of 116 adolescents (99 males and 17 females) aged 12 to 19 on parole in the State of Rio de Janeiro were interviewed using the screening interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children -- Present and Lifetime (KSADS-PL). Data were collected between May 2002 and January 2003. Of 373 male and 58 female adolescents present in May 2002 in the largest institution that gives assistance to adolescents on parole in the city of Rio de Janeiro, 119 subjects were assessed (three of them refused to participate). Their average age was 16.5 years with no difference between genders. The screening interview was positive for psychopathology for most of the sample, with the frequencies of the suggested more prevalent psychiatric disorders being 54% for attention-deficit/hyperactivity disorder, 77% for conduct disorder, 41% for oppositional defiant disorder, 57% for anxiety disorder 57, 60% for depressive disorder 60, 63% for illicit drug abuse, and 58% for regular alcohol use. Internalizing disorders (depressive disorders, anxiety disorders and phobias) were more prevalent in the female subsample. There was no significant difference in the prevalence of illicit drug abuse between genders. There were more male than female adolescents on parole and failure to comply with the sentence was significantly more frequent in females. The high prevalence of psychopathology suggested by this study indicates the need for psychiatric treatment as part of the prevention of juvenile delinquency or as part of the sentence. However, treatment had never been available for 93% of the sample in this study.
Between August 29 and September 7, 2005, almost all New Orleans residents were evacuated from the area in the aftermath of Hurricane Katrina. News reports indicate that almost 130,000 New Orleans ...Evacuees (NOEs) were evacuated to Houston, Texas, the largest recipient of the civilian population from New Orleans. Some of these NOEs were active participants in the illicit drug market in New Orleans prior to the hurricane. The period between the flooding and the nearly complete evacuation of New Orleans as well as their subsequent displacement to Houston and other locations provided unique opportunities to study what occurs when illicit drug markets are disrupted, since populations of illicit drug users and purchasers could no longer routinely obtain their drugs in predictable ways. Utilizing qualitative data from in-depth interviews and focus groups, this article describes the ways NOEs (1) managed their drug acquisition and use following evacuation; (2) located new sources of drugs in Houston and elsewhere by tapping into shared drug culture; and (3) gained access to and learned the argot for drugs in the local drug market in new settings. This report contributes to the nascent literature on disrupted drug markets.
Children affected by their parents’ dual drug use and HIV/AIDS face considerable challenges to their psychosocial development, including parent dysfunction and foster care placement. While HIV/AIDS ...may increase parents’ mobilization of social support, their drug use may restrict who is available to help them, with potential implications to the adjustment of their children with whom they remain in contact. This study sought to identify dually affected children’s living situations, and parent and parent’s support network factors as correlates of children’s externalizing problem behaviors. An urban community sample of 462 HIV seropositive, current or former drug-using parents were queried about their children aged 5–15 years old. One hundred ninety-four children were reported by 119 parents. The outcome was children’s externalizing behaviors of ever having been suspended or expelled from school, criminal-justice system involvement, or illicit drug or heavy alcohol use. Independent variables included kin and drug users in parent’s support network. Generalized estimating equations were used to adjust for the potential correlation of children of the same parent. Among parents, 63% were mothers, 57% current opioid or cocaine users, 85% were African American, 35% had AIDS or CD <200, and 53% had high depressive symptoms (CES-D ≥ 16); median age was 38. Among children, median age was 12; 23% lived with the nominating parent, 65% with other family, and 11% in non-kin foster care. While only 34% of parents reported child custody, 43% reported daily contact with their child, and 90% reported high emotional closeness. Parents reported externalizing behaviors among 32% of the children. Logistic regression indicated that externalizing behavior was positively associated with parent’s physical limitations and proportion of illicit drug users in parent’s support network. A significant interaction was found indicating that the effect of parent’s support network-level drug use was greater for children living with versus not living with the parent. The model adjusted for parent’s current drug use and depressive symptoms, which were not significant. Results indicate that while only a minority of these dually affected children lived with the parent, the parents’ physical limitations and embeddedness in drug using support networks, particularly if living with their children, was associated with the children’s maladjustment. It is plausible that these factors interfere with parenting, expose the children to conflict or adverse social influences, or obligate children to assume caregiving for their parent. While dually affected children’s contact with their parents may have important benefits, results suggest it presents ongoing needs for intervention with the children, their parents, and caregivers.
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