HIV risks of rural women using methamphetamine within family and social networks

Methamphetamine (MA) is considered the drug of choice in many rural communities, yet little is known about rural MA using women's social networks and patterns of use that predispose them to HIV infection. Women are socialized to be communal and value connections with others. Studies of urban women indicate they are more likely than men to transition to injection behaviors because of the influence of a romantic partner and to receive their first injection from a romantic partner. Within romantic relationships, urban women perceive drug use as a tool for bonding, creating intimacy, and maintaining the relationship with partners. Rural women may be more likely to behave in accordance with gender roles and the values associated with them, because of the conservative and traditional nature of rural areas. Few studies have examined the rural women's drug using networks and their contribution to HIV risk. A social ecological perspective can provide the needed integration of individual behaviors and beliefs with the larger social context. Interactions between the woman and her family and drug using peers were the focus of this qualitative study with 25 rural MA using women. Data were analyzed using a five-step qualitative data coding procedure to identify themes related to drug use and family factors that increase HIV risks. Women indicated MA use within dense social networks that included families. Emergent themes included early initiation into drug use by family, including injecting children. Sexual risks included being high for all sexual activity and no condom use.