Impact of Changes in Criminal-Legal Practices During the COVID-19 Pandemic on the HIV Risk Behaviors of Women Who Use Drugs: Protocol for a Multimethods Qualitative Study.

Impact of Changes in Criminal-Legal Practices During the COVID-19 Pandemic on the HIV Risk Behaviors of Women Who Use Drugs: Protocol for a Multimethods Qualitative Study.

Publication date: Dec 20, 2024

HIV risk behavior in women who use drugs is related to myriad psychosocial issues, including incarceration. The experience of incarceration elevates women’s HIV risk by disrupting social networks, housing, employment, and access to health care. During the COVID-19 pandemic, changes in criminal-legal practices resulted in decreased incarceration, especially among women. These changes may have largely altered HIV risk among women who use drugs, depending on their access to care in the community. This study seeks to build knowledge about the impact of shifts in criminal-legal practices during the COVID-19 pandemic on HIV risk behaviors of justice-involved women who use drugs. Qualitative methods are used to gather and analyze women’s narratives about their life experiences before and during the COVID-19 pandemic, with a focus on individual and structural determinants of HIV risk behaviors. Thirty formerly incarcerated women with a history of substance use are being recruited through collaboration with community partners. Each participant completes a sociodemographic survey and two interviews. The first interview uses a life history instrument that invites participants to reflect on key turning points in their lives. The second interview uses a calendar approach to gather information about participants’ lives during the first year of the COVID-19 pandemic (March 2020-March 2021). The interviews (1 hour each) are audio-recorded and transcribed for analysis. Rapid Qualitative Inquiry and thematic analysis are being used to manage, organize, and interpret the data. The study team will collaborate with a subset of participants to develop digital stories about their COVID-19 experiences, a process that allows for member-checking and triangulation. Findings will be disseminated to program and policy makers in academic venues, community settings, and social service agencies. To date, 10 women’s data have been collected. In total, two themes have been identified in this preliminary data: (1)the chaos and instability of participants’ lives increased during the COVID-19 pandemic: participants reported a wide range of psychosocial and health problems and limited engagement with social service systems. Interaction with criminal-legal systems was rife with uncertainty; participants described living in a state of limbo, which was extremely stressful. (2) When asked to describe a “turning point” in their lives, many participants attributed their substance use to the traumatic loss of a child due to death, incarceration, or termination of parental rights. During the COVID-19 pandemic, participants’ struggles to cope with these unresolved experiences of grief and loss were intensified by the widespread death and dying of the pandemic. Preliminary findings suggest that HIV risk factors increased for participants during the COVID-19 pandemic and invite further investment in community-based harm reduction programs, especially housing, that support women who use drugs. Interventions that address experiences of maternal grief and loss may reduce women’s substance use. DERR1-10. 2196/58285.

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Concepts Keywords
Hiv Adult
Incarceration audio-recorded
Psychosocial carceral
Women coronavirus
corrections
COVID-19
COVID-19
Criminal Law
criminal-legal systems
drug
Drug Users
Female
health care
HIV
HIV Infections
HIV risk
Humans
Middle Aged
pandemic
Pandemics
Prisoners
psychosocial
qualitative
qualitative method
Qualitative Research
Risk-Taking
SARS-Cov-2
socio-demographic
substance use
Substance-Related Disorders
thematic analysis
women

Semantics

Type Source Name
disease MESH COVID-19 Pandemic
disease MESH access to health care
disease IDO history
disease MESH substance use
disease IDO process
disease MESH uncertainty
disease MESH death
disease IDO country
disease MESH infections
disease MESH interpersonal violence
disease MESH sexual assault
drug DRUGBANK Methadone
disease IDO infection
disease MESH emergency
drug DRUGBANK Etoperidone
drug DRUGBANK Rasagiline
disease IDO facility
drug DRUGBANK Silver
drug DRUGBANK Dihydrostreptomycin
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH anxiety
disease MESH depression
disease MESH etiology
disease MESH complications
drug DRUGBANK Methionine
disease IDO production
disease MESH AIDS
disease MESH Hepatitis
disease IDO quality
drug DRUGBANK Ethanol
disease MESH sexually transmitted infections
drug DRUGBANK Guanosine
disease IDO intervention
disease MESH social vulnerability
drug DRUGBANK Diethylstilbestrol
disease IDO symptom
pathway REACTOME Reproduction
disease MESH HIV Infections

Original Article

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