학술논문

First Report of Gender Based Violence as a Deterrent to Methadone Access Among Females Who Use Heroin in Dar es Salaam, Tanzania
Document Type
Original Paper
Source
AIDS and Behavior. July 2017 21(7):2093-2100
Subject
Heroin
HIV
Female drug users
Methadone
Gender-based violence
Language
English
ISSN
1090-7165
1573-3254
Abstract
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.