ArticleHarm reduction journal2025
Qualitative insights into drug use safety strategies and social support among sexual minority women who inject drugs in Baltimore, Maryland.
Article in Harm reduction journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Let the girls know, "you can come here": qualitative experiences with harm reduction and health services among women who use drugs in Chicago.Harm reduction journal · 2026Article
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5 authors.
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Abstract
backgroundSexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID's strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies.
methodsWe conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants' sexual orientation and gender identities, social networks and support systems, drug use behaviors and HIV risk, and experiences accessing services. Using an inductive thematic analysis approach, we examined emergent themes related to drug use, social support, safety, and HIV and identified key safety strategies and social support experiences for SMWWID.
resultsSMWWID employed various strategies to "stay safe," which they primarily interpreted as ensuring overdose safety (i.e., using drugs in the presence of others, carrying Naloxone, purchasing strategies), and additionally as infectious disease safety (i.e., avoiding syringe sharing, using sterile syringes) and avoiding threats of violence (i.e., maintaining situational awareness while using drugs). Romantic or sexual partners, family and friends, and the wider community were sources of social support for overdose safety, and family and friends also provided material support (e.g., financial, housing). Syringe sharing with romantic partners and threats of violence from people in the community detracted from SMWWID's safety.
conclusionSMWWID in this sample reported strong safety prioritization while using drugs, often facilitated by their social support systems. Harm reduction interventions that consider SMWWID's relationships, including those that aim to improve social connectedness, may better meet the needs of SMWWID, thereby enhancing safety.
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