title: Sexual pleasure and sexual risk among women who use methamphetamine: a mixed methods study.
abstract: BACKGROUND
  The intersection of drug use, sexual pleasure and sexual risk behaviour is rarely explored when it comes to poor women who use drugs. This paper explores the relationship between sexual behaviour and methamphetamine use in a community-based sample of women, exploring not only risk, but also desire, pleasure and the challenges of overcoming trauma.
  
  
  METHODS
  Quantitative data were collected using standard epidemiological methods (N=322) for community-based studies. In addition, using purposive sampling, qualitative data were collected among a subset of participants (n=34). Data were integrated for mixed methods analysis.
  
  
  RESULTS
  While many participants reported sexual risk behaviour (unprotected vaginal or anal intercourse) in the quantitative survey, sexual risk was not the central narrative pertaining to sexual behaviour and methamphetamine use in qualitative findings. Rather, desire, pleasure and disinhibition arose as central themes. Women described feelings of power and agency related to sexual behaviour while high on methamphetamine. Findings were mixed on whether methamphetamine use increased sexual risk behaviour.
  
  
  CONCLUSIONS
  The use of mixed methods afforded important insights into the sexual behaviour and priorities of methamphetamine-using women. Efforts to reduce sexual risk should recognize and valorize the positive aspects of methamphetamine use for some women, building on positive feelings of power and agency as an approach to harm minimization.
authors.affiliation: Urban Health Program, RTI International, USA. jlorvick@rti.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lorvick
authors.forename: Philippe
authors.initials: P
authors.lastname: Bourgois
authors.forename: Lynn D
authors.initials: LD
authors.lastname: Wenger
authors.forename: Sonya G
authors.initials: SG
authors.lastname: Arreola
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lutnick
authors.forename: Wendee M
authors.initials: WM
authors.lastname: Wechsberg
authors.forename: Alex H
authors.initials: AH
authors.lastname: Kral
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D003625:Data Collection; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D057181:Pleasure; D012309:Risk-Taking; D012725:Sexual Behavior; D047568:Unsafe Sex; D055815:Young Adult
chemical_list: D008694:Methamphetamine