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Try out PMC Labs and tell us what you think. Learn More. Drug and alcohol use have been associated with increased risk for sexual violence, but there is little research on sexual violence within the context of drug use among young adult opioid users. Participants reported frequent incidents of sexual violence experienced both personally and by their opioid using peers.

Recommendations to reduce sexual violence among young adult opioid users include education for users and service providers on the risk of involvement in sexual violence within drug using contexts and efforts to challenge perceptions of acceptability regarding sexual violence. They are also the second most common drug class through which Americans are initiated into illicit drug use; while 2.

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Research has found that young adults frequently use POs nonmedically with peers in social settings e. When taken in large doses or in combination with other substances e. In addition to rape, the term sexual violence as used here encompasses other sexual violations, including sexual harassment, coercion e.

Alcohol is by far the most common substance associated with sexual violence in the United States, with some studies estimating the presence of alcohol in up to half of all instances of sexual violence, either by the victim, the perpetrator, or both Abbey et al. Other research presents lower estimates, but the presence of alcohol and other drugs remains substantial. For example, Kilpatrick et al. Little research focuses on the specificity of drugs used, including POs, in association with sexual violence.

Preliminary research suggests that nonmedical PO use, like the use of other illicit drugs and alcohol, may place users at heightened risk for sexual violence Argento et al. The social context in which substance use occurs is an important factor influencing the risk for harm; therefore, understanding the contexts in which young adults use opioids and other drugs could be informative in preventing sexual violence among this population.

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The current article contributes to research on sexual violence within drug using contexts by specifically focusing on the experiences of young adult users of opioids i. Although participants were recruited based on their opioid use, many users reported polysubstance use; therefore, ample data will be presented in which participants discussed the use of nonopioid drugs and their contribution to sexual violence.

This article reports data from a mixed-methods study exploring the sexual and drug use behavior of young adult opioid users in New York City. Qualitative data are used to provide context in understanding how drug use, sexual behavior, and sexual violence intertwine; quantitative data are presented for key variables to illustrate the extent to which a sample of young adult opioid users experience different types of sexual violence.

The present analysis includes data from 46 participants who were interviewed in the formative qualitative portion of the study and participants who have been interviewed to date from July 17,through February 13, in the subsequent and ongoing quantitative component. Eligibility for qualitative interviews was determined through self-report using a brief verbal screening protocol. Participants were deemed eligible by meeting the following criteria: live in one of the five boroughs of New York City; report lifetime use of POs for nonmedical reasons most reported use in the past 30 days ; speak English or Spanish, and be able to provide informed consent.

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Of the 46 participants included in the qualitative sample, 23 were referred by service providers, key informants, or other research projects and Adult want sex tonight Hughes were recruited via snowball sampling from other participants. Interviews were in-depth and semistructured, and lasted approximately 90 minutes each. Participants received a small monetary compensation at the conclusion of the interview. Topical domains addressed in interviews included drug use trajectories, social contexts of opioid use, sexual and drug using networks and practices.

When reporting involvement in sexual violence, participants described incidents that occurred while using opioids as well as other drugs e. In some instances, the particular drugs being used at the time sexual violence occurred were not specified by participants. Therefore, we seek to report experiences related to sexual violence as described by young adult opioid users but do not intend for these experiences to be understood as exclusively occurring during PO or heroin use. Opioid use often occurred in combination with other substances such as alcohol and other prescription drugs e.

Interviews were digitally audio-recorded and transcribed verbatim. An initial code list based on these themes was established and refined using a subset of transcripts, with a final code list used to code the remaining transcripts. Participants were asked to recruit fellow opioid users, and for a vast majority of participants, PO use preceded heroin use, although not all participants conformed to this dominant pattern.

After completing a screening and the Adult want sex tonight Hughes interview, each seed was asked to refer to the study up to three eligible peers from their social network. As is typical in RDS methodology, the 14 seeds are included within the quantitative sample of Eligibility was assessed using a combination of screening techniques, including a verbal questionnaire to collect self-reported data on drug use in the past 30 days, a visual quiz in which participants were asked to identify pictures of POs, and, for those who reported recent drug injection, a visual assessment for injection marks.

To confirm recent opioid use approximately the past 2—4 daysurine samples were also collected and tested for the presence of methadone, opiates, and oxycodone using a point-of-care screening device, the iCup panel manufactured by Alere Toxicology Services in Portsmouth, Virginia. In doing so, we were able to successfully identify eligible participants who had used opioids in the last 30 days and excluded those who were not current opioid users. For prospective participants who appeared to be older than their early 20s, age was verified by photo identification.

Structured interviews lasted between 90 and minutes and included questions on drug use, sexual behavior, sexual and injection networks, overdose, drug treatment, HIV and hepatitis C HCV knowledge and testing history. The Sexual Violence Questionnaire asks whether participants have experienced various types of sexual violence and, if so, how many times.

Questions include whether participants have witnessed sexual violence, have ever been touched in a sexual way without their consent, whether someone has ever had sex with them without their consent, and whether they have ever been propositioned for sex in exchange for drugs or money. The structured questionnaire also includes questions about sexual exchanges e. Data from structured assessments were analyzed using MatLab Rb. Of the 46 participants in the qualitative sample, 27 were male, 18 female, and 1 was transgender female.

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The mean age of participants was Fourteen attended some high school, 9 had received a high school diploma or General Educational Development GED14 had attended some college, and 9 were either college graduates or had some postgraduate education. Sociodemographic characteristics of the participants included in the quantitative sample are presented in Table 1.

Participants reported having experienced a range of forms of sexual violence, from sexual coercion or being pressured to have sex in drug using contexts e. Participants in the qualitative interviews described their first experiences of opioid use as social. Most qualitative participants described their first use of opioids as involving the nonmedical use of POs, which they used at parties and while spending time with friends.

In these contexts, mixing POs with alcohol and other drugs was common. Veronica, for example, described attending parties in high school where she would mix and share pills with her friends. There were all these pills on the table constantly. Veronica, 22, White, Female. Most participants in the quantitative sample reported initiating PO use in their teens; the mean age of nonmedical PO initiation was However, participants continued to frequently use opioids with others, and some reported having sex while high on POs and other drugs.

Many participants described POs as facilitating casual sex when used with drug using peers and reported engaging in sex with casual partners while high on POs. Alissa, 22, White, Female.

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Interviewer: So it really looks like of all the prescription opioid users, the females that you currently know, which I count three … You had sex, you had sex with three of them. Interviewer: Okay. Is that common to have sex with other female partners among your group? Participants also described the use of opioids and other drugs as creating a sense of connection with partners that facilitated sex. Elizabeth, for example, described how she felt closer to her partner because they used drugs together.

Elizabeth, 19, White, Female. Although many participants described the use of opioids Adult want sex tonight Hughes facilitating sexual encounters that were consensual, participants also described how they increased risk for sexual violence. Participants described how using POs can place users in unconscious or semiconscious states, potentially heightening risk for victimization. But if it comes down to it, a guy will be more focused because he has to do the work, and the girl could just lay down there and just be like, still be out.

Zeus: What do you mean? Zeus, 23, Male, White. Participants described how users, especially females under the influence of opioids and other drugs, were viewed as easy to have sex with and were at risk for sexual violence.

Mary, for example, imitated the way some of her male peers perceive females who get very high and black out. Anyone high tonight? Although all participants in the qualitative portion of the study had ificant personal experience with opioid use, interviews revealed that many held stigmatizing attitudes toward drug users that are common within mainstream society, with users characterizing opioid addiction as degrading and weak.

Joe, for example, was a dealer who related Adult want sex tonight Hughes when he was being taught how to sell drugs, his boss made it clear to him that he could use marijuana and drink alcohol, but that there was a stigma attached to opioid use.

He described how he would be seen as crossing an undesirable line if he were to use POs or heroin, although he did ultimately use POs himself despite these perceptions. This negative view of drug users, especially those who were known or assumed to be physically dependent on opioids, also extended to how they were perceived sexually, both by their peers and by society at large. Participants reported being insulted sexually because of their drug use, with negative sexual characteristics ascribed to them through verbal insults.

Some male participants indicated a belief that individuals, especially females who are drug dependent, do not deserve sexual respect, and some participants referred to female drug users in sexually demeaning terms. An example of these dynamics is provided by Zeus who described an incident involving a female he knew who accused three other drug users of raping her while she was high. from the structured assessment support these qualitative findings. Thirty percent of participants reported having been sexually insulted about their drug use, and this was especially common among females.

Table 2 presents this and other structured data from the sexual violence questionnaire developed and informed by our qualitative interviews. In addition to such perceptions, qualitative interview participants also reported being viewed as readily willing to exchange sex for money or drugs.

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