Impact of Changes in Criminal-Legal Practices During the COVID-19 Pandemic on the HIV Risk Behaviors of Women Who Use Drugs: Protocol for a Multimethods Qualitative Study
Notice bibliographique
Résumé
BACKGROUND: HIV risk behavior in women who use drugs is related to myriad psychosocial issues, including incarceration. The experience of incarceration elevates women's HIV risk by disrupting social networks, housing, employment, and access to health care. During the COVID-19 pandemic, changes in criminal-legal practices resulted in decreased incarceration, especially among women. These changes may have largely altered HIV risk among women who use drugs, depending on their access to care in the community. OBJECTIVE: This study seeks to build knowledge about the impact of shifts in criminal-legal practices during the COVID-19 pandemic on HIV risk behaviors of justice-involved women who use drugs. METHODS: Qualitative methods are used to gather and analyze women's narratives about their life experiences before and during the COVID-19 pandemic, with a focus on individual and structural determinants of HIV risk behaviors. Thirty formerly incarcerated women with a history of substance use are being recruited through collaboration with community partners. Each participant completes a sociodemographic survey and two interviews. The first interview uses a life history instrument that invites participants to reflect on key turning points in their lives. The second interview uses a calendar approach to gather information about participants' lives during the first year of the COVID-19 pandemic (March 2020-March 2021). The interviews (1 hour each) are audio-recorded and transcribed for analysis. Rapid Qualitative Inquiry and thematic analysis are being used to manage, organize, and interpret the data. The study team will collaborate with a subset of participants to develop digital stories about their COVID-19 experiences, a process that allows for member-checking and triangulation. Findings will be disseminated to program and policy makers in academic venues, community settings, and social service agencies. RESULTS: To date, 10 women's data have been collected. In total, two themes have been identified in this preliminary data: (1)the chaos and instability of participants' lives increased during the COVID-19 pandemic: participants reported a wide range of psychosocial and health problems and limited engagement with social service systems. Interaction with criminal-legal systems was rife with uncertainty; participants described living in a state of limbo, which was extremely stressful. (2) When asked to describe a "turning point" in their lives, many participants attributed their substance use to the traumatic loss of a child due to death, incarceration, or termination of parental rights. During the COVID-19 pandemic, participants' struggles to cope with these unresolved experiences of grief and loss were intensified by the widespread death and dying of the pandemic. CONCLUSIONS: Preliminary findings suggest that HIV risk factors increased for participants during the COVID-19 pandemic and invite further investment in community-based harm reduction programs, especially housing, that support women who use drugs. Interventions that address experiences of maternal grief and loss may reduce women's substance use. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58285.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,051 | 0,031 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,003 |
| Méta-épidémiologie (sens large) | 0,003 | 0,003 |
| Bibliométrie | 0,004 | 0,003 |
| Études des sciences et des technologies | 0,011 | 0,005 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,006 | 0,007 |
| Intégrité de la recherche | 0,005 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,046 | 0,006 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».