Social support and recovery efforts among Mexican female sex workers who inject drugs

Social support research on female sex workers who inject drugs (FSW-IDUs) is scarce. We aim to describe: (1) the social support that FSW-IDUs receive from family and intimate partners, and (2) participants' beliefs regarding the relationship between social support, drug use and recovery. In 2009, we purposefully recruited 47 FSW-IDUs from an HIV risk reduction intervention study in Tijuana, Mexico. Semi-structured interviews were digitally recorded. We coded the transcribed interviews using atlas.TI, and used data reduction and descriptive analysis techniques to elucidate emergent themes. On average, participants were 36 years old, and initiated drug use at age 17, sex work at age 21, and injection drug use at age 22. Participants gave examples of positive (i.e., encouraging recovery) and negative (i.e., enabling maintained/ increased drug use) instrumental and emotional social support, and the absence or removal of support, and consequences for drug use and recovery efforts. Women received financial, childcare, and housing support, and emotional support in the form of respect, caring, and companionship. Problematic social support was identified as positive support causing emotional discomfort, guilt or shame among participants, which they believed led to greater chance of relapse. Drug recovery interventions targeting FSW-IDUs may benefit from addressing the social network dynamics affecting substance use and rehabilitation activities. Incorporating family therapy techniques and social support into Mexican drug treatment programs can be considered in this era of post-drug policy reform expansion of rehabilitation services. Findings should be replicated in a larger study.