Incarcerated Women's Strategies to Reduce the Influence of “Risky Relationships” on Drug Use

Background: Research has shown that incarcerated women’s risky health behaviors for HIV and drug use are influenced by their relationships. Less is known about whether women’s changing perceptions of these relationships over the life course can reduce their influence and corresponding risk. This qualitative study analyzes women’s strategies to decrease the influence of risky relationships as a health-promoting behavior that can affect their drug use.

Methods: This study involves qualitative data analysis of face-to-face interviews with 30 incarcerated drug-using women who participated in a HIV risk reduction intervention. Women in rural jails in one Appalachian state were randomly selected and screened before taking part in at least 4 motivational interviewing sessions. Interview transcripts were transcribed, analyzed, and coded according to Grounded Theory methods.

Results: In preliminary qualitative analysis, three themes emerged in women’s evaluation of the relationships that influence their drug use behavior and comorbid mental health conditions. Women described how: 1) relationships of shared drug use, even those that provide support, may need to be ended; 2) to promote their mental health and avoid drug use as a coping behavior, they needed to develop strategies to avoid abusive relationships; and 3) they could substitute the draw of drug use within risky relationships with a positive emphasis on oneself or other relationships.

Conclusions: This study indicates that women are influenced by the social environments that shape their complex health issues. Future interventions based on a life course perspective to women’s substance abuse can target relationship-based health-promoting behaviors.