Angela R Bazzi1, Jennifer L Syvertsen2, María Luisa Rolón3, Gustavo Martinez4, Gudelia Rangel5, Alicia Vera3, Hortensia Amaro6, Monica D Ulibarri7, Daniel O Hernandez8, Steffanie A Strathdee9. 1. Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, 4th floor, Boston, MA 02118, USA. Electronic address: abazzi@bu.edu. 2. Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174W. 18th Avenue, Columbus OH 43210, USA. 3. Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0507, USA; Facultad de Medicina, Universidad Xochicalco, Rampa Yumalinda 4850, Colonia Chapultepec Alamar C.P. 22540, Tijuana, Baja California, México. 4. Federación Mexicana de Asociaciones Privadas, Plutarco Elías Calles No. 744 Norte, Col. Progresista, C.P. 32310, Ciudad Juárez, Chihuahua, México. 5. Comisión de Salud Fronteriza México-Estados Unidos, Sección México, Paseo del Centenario #10851, Zona Río. C.P. 22010, Tijuana, Baja California, México; Secretaría de Salud, Homero 213, piso 19, Col. Chapultepec Morales, Delegación Miguel Hidalgo C.P. 11570, México, D.F. 6. School of Social Work and Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Montgomery Ross Fisher Building, Room 221 669W. 34th St., Los Angeles, CA 90089. 7. Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0849, USA; California School of Professional Psychology, Alliant International University-San Diego, San Diego, CA. 8. School of Medicine, University of California, Davis, 4610 X Street, Sacramento, CA 95817, USA. 9. Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla CA 92093-0507, USA.
Abstract
BACKGROUND: Available drug treatment modalities may inadequately address social and structural contexts surrounding recovery efforts. METHODS: This mixed methods analysis drew on (1) surveys with female sex workers and their intimate male partners and (2) semi-structured interviews with a subsample of 41 couples (n=82 individuals, 123 total interviews) in Northern Mexico. Descriptive and content analyses examined drug cessation and treatment experiences. RESULTS: Perceived need for drug treatment was high, yet only 35% had ever accessed services. Financial and institutional barriers (childcare needs, sex-segregated facilities) prevented partners from enrolling in residential programs together or simultaneously, leading to self-treatment attempts. Outpatient methadone was experienced more positively, yet financial constraints limited access and treatment duration. Relapse was common, particularly when one partner enrolled alone while the other continued using drugs. CONCLUSIONS: Affordable, accessible, evidence-based drug treatment and recovery services that acknowledge social and structural contexts surrounding recovery are urgently needed for drug-involved couples.
BACKGROUND: Available drug treatment modalities may inadequately address social and structural contexts surrounding recovery efforts. METHODS: This mixed methods analysis drew on (1) surveys with female sex workers and their intimate male partners and (2) semi-structured interviews with a subsample of 41 couples (n=82 individuals, 123 total interviews) in Northern Mexico. Descriptive and content analyses examined drug cessation and treatment experiences. RESULTS: Perceived need for drug treatment was high, yet only 35% had ever accessed services. Financial and institutional barriers (childcare needs, sex-segregated facilities) prevented partners from enrolling in residential programs together or simultaneously, leading to self-treatment attempts. Outpatientmethadone was experienced more positively, yet financial constraints limited access and treatment duration. Relapse was common, particularly when one partner enrolled alone while the other continued using drugs. CONCLUSIONS: Affordable, accessible, evidence-based drug treatment and recovery services that acknowledge social and structural contexts surrounding recovery are urgently needed for drug-involved couples.
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