This study is designed to examine the nature of the relationship(s) between drug use, partner violence victimization, and HIV risk among inner city women. The study builds on our prior examination of exposure to and participation in violence among Puerto Rican drug using social networks. The prior study found high rates of violence in the target population and suggested the importance of a targeted examination of partner violence victimization among women drug users, an understudied population at great risk for HIV and health consequences, risk that may be enhanced considerably by exposure to violence. Specifically, the proposed study will investigate the impact of partner violence on four psychosocial and epidemiological measures among women drug users: 1) the quantity/frequency of their drug use; 2) their readiness for drug treatment; 3) their drug-related and sexual risk for HIV and other infections; and 4) their actions to leave abusive relationships (and as a result be more available for risk reduction intervention). Because we hypothesize that the relationship between exposure to partner violence and these outcomes is mediated by several psychosocial factors that shape the life situation and experience of study participants, we also will examine a set of influences on the connection between our independent variable (partner violence) and our outcome variables. Existing research suggests that the factors that appear to be especially salient are: 1) women's commitment to sustaining the status quo (including their level of satisfaction, the quality of alternative behaviors open to them, their irretrievable investments in their current situation, their cultural norms about acceptable/appropriate behavior, and their dependence on the relationship financially, for drugs, and for other things of value to them), and 2) women's behavioral controls/supports (including their locus of control, self efficacy, social supports and coping strategies). In this study, we will examine these relationships among active (out-of-treatment) women drug users by recruiting and interviewing 500 drug-using women, who are expected, based on prior research, to exhibit a range of exposure to partner violence. We will also conduct focus groups with male abusers to inform our instrument construction and the interpretation of findings. By examining relationships between level of exposure to partner violence, mediating levels of social support and personal characteristics, and risk behaviors, the proposed project sharpens the focus of our prior research on rates and kinds of violence among Puerto Rican Drug users by: 1) narrowing our research attention to a specific type of frequent and consequential drug-related violence; 2) concentrating on women drug users as common victims of drug-related violence; 3) examining specific direct and indirect health consequences for women of exposure to partner violence; and 4) comparatively including African American, Hispanic, and White women. This study will allow our research team to use to identify salient points for culturally competent HIV and related health interventions. Further, by closely exploring women's conception of partner violence committed against them through the use of several qualitative methods, we will be able to understand better how women respond to partner violence, why they respond in these ways, and variations in response relative to victim understanding, factors that are critical to developing public health interventions.
| Straiker, Alex; Mackie, Ken (2006) Cannabinoids, electrophysiology, and retrograde messengers: challenges for the next 5 years. AAPS J 8:E272-6 |
