<p> Many studies have shown that men and women who inject drugs differ in their risk of contracting HIV, with women being at higher risk. However, the risk factors between women and men are less well understood, and more knowledge about them can inform gender-sensitive prevention and treatment for people who inject drugs (PWIDs). Research synthesis and meta-analysis was implemented on studies conducted with adult injection drug users that made gender comparisons on biological, behavioral, and social- structural risk factors. Fifty-five studies in the research synthesis provided data for inclusion in the meta-analysis. The analysis yielded many significant findings. With regard to biological risk factors women were one and half times or more as likely to engage in vaginal sex (<i>OR</i>=1.60, <i>p</i>=0.000), engage in oral sex (<i>OR</i>=1.59, <i>p</i>=0.001), to experience injecting problems such as difficulty locating a vein (<i> OR</i>=1.71, <i>p</i>=0.000), and STIs (<i>OR</i>=1.66, <i> p</i>=0.001). With regard to behavioral injection risk factors, women were modestly more likely to engage in receptive sharing (<i>OR</i>=1.12, <i> p</i>=0.01), inject more frequently (<i>OR</i>=1.18, <i> p</i>=0.01), and were two and a half times more likely to engage in receptive sharing of injecting equipment with sex partners (<i>OR</i>=2.51, <i> p</i>=0.000) while women were less likely to share equipment with friends (<i>OR</i>=.79, <i>p</i>=.0001). With regard to behavioral, sexual risk factors women were significantly more likely to engage in unprotected sex (<i>OR</i>=1.41, <i>p</i>=0.05), have multiple sex partners (<i>OR</i>=1.72, <i>p</i>=0.01), have steady sex partners as opposed to casual sex partners (<i>OR</i>=1.87, <i> p</i>=0.000), and were nearly four times more likely to engage in survival sex work (<i>OR</i>=3.77, <i>p</i>=0.000). With regard to social-structural risk factors, women were nearly ten times more likely to experience sexual violence (<i>OR</i>=9.6, <i>p</i>=0.000) while women were significantly less likely to experience physical violence that was not sexual (<i>OR</i>=0.60, <i>p</i>=0.000). Women were twice as likely to experience poor health status (<i>OR</i>=2.08, <i> p</i>=0.000). Significant heterogeneity was found among all analyses. Overall, the findings of this study provides evidence that women who inject drugs experience greater HIV risks in all areas than men who inject drugs, suggesting that future harm reduction strategies should be tailored to women’s and men’s specific risk factors.</p>
| Identifer | oai:union.ndltd.org:PROQUEST/oai:pqdtoai.proquest.com:10196162 |
| Date | 06 December 2016 |
| Creators | Pennington, Laurie E. |
| Publisher | New York University |
| Source Sets | ProQuest.com |
| Language | English |
| Detected Language | English |
| Type | thesis |
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