The intersection of women’s sexual pleasure and injection drug use

Abstract

Background: There is a dearth of literature concerning the sexual behaviors of women who inject drugs. The existing literature emphasizes the violence, trauma, and social disadvantage experienced by these women and obscures any sense of agency or sexual pleasure. This omission imperils our ability to develop effective interventions for women, ignores the true context of their sexual and injection practices, and presumes women to be free of agency and thus at the will of external social, environmental, and economic factors. This qualitative study strives to extend the boundaries of conventional risk-focused research to understand the complex and multidimensional sexual practices of women who inject drugs. Methods: Purposive sampling was used to select women who inject drugs from a syringe exchange program in New York City. The principal investigator and trained study staff conducted interviews with 26 women. The interview transcripts were thematically coded in Atlas.ti with a grounded theory approach to understand the concerns, actions, and practices to further explain patterns. Results: Four themes emerged with respect to women’s descriptions of their sexual and injection experiences: (a) linguistic parallels of sexual and injection experiences, (b) substituting sex with injection drug use, (c) pleasure, and (d) injection drug use as intimacy. Our findings indicated that there was much positive discourse about sexual experiences and injection drug practices, with some women describing injecting as a substitute for negative sexual experiences and others noting that injection drug use served as a foundation for intimacy and eroticism in a relationship. Conclusions: In contrast to the literature, women who inject drugs demonstrated power and agency and discussed pleasurable sexual experiences. Ultimately, interventions should recognize the realities of women’s experiences to help empower them to practice safer sexual and injection practices.

Keywords:

• Harm reduction
• injections
• injection drug use
• intravenous
• sexual behavior
• sexual pleasure

Additional information

Funding

Caroline Katzman’s time involved in this research was funded by a stipend from the National Institute on Drug Abuse (NIDA)-funded Substance Abuse Research Education and Training (SARET) Program [NIDA 5R25DA022461]. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Notes on contributors

Caroline Katzman

Ellen Tuchman has made substantial contributions to conception and design, acquisition of data, coding, and coauthoring of the msnuscript. She has given final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Caroline Katzman’s contributions were coding, interpretation of the data, drafting, and revising the manuscript critically for important intellectual content.

Ellen Tuchman

Ellen Tuchman has made substantial contributions to conception and design, acquisition of data, coding, and coauthoring of the msnuscript. She has given final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Caroline Katzman’s contributions were coding, interpretation of the data, drafting, and revising the manuscript critically for important intellectual content.