title: Live to tell: Narratives of methamphetamine-using women taken hostage by their intimate partners in San Diego, CA.
abstract: BACKGROUND
  Hostage-taking, an overlooked phenomenon in public health, constitutes a severe form of intimate partner violence and may be a precursor to female homicide within relationships characterized by substance use. Criminal justice studies indicate that most hostage incidents are male-driven events with more than half of all cases associated with a prior history of violence and substance use. Methamphetamine use increases a woman's risk of partner violence, with methamphetamine-using individuals being up to nine times more likely to commit homicide. As homicide is the most lethal outcome of partner violence and methamphetamine use, this study aims to characterize the potential role of hostage-taking within these intersecting epidemics.
  
  
  METHODS
  Methamphetamine-using women enrolled in an HIV behavioural intervention trial (FASTLANE-II) who reported experiences of partner violence were purposively selected to participate in qualitative sub-studies (Women's Study I & II). Twenty-nine women, ages 26-57, participated in semi-structured interviews that discussed relationship dynamics, partner violence, drug use and sexual practices.
  
  
  RESULTS
  Findings indicated four cases of women being held hostage by a partner, with two women describing two separate hostage experiences. Women discussed partner jealousy, drug withdrawal symptoms, heightened emotional states from methamphetamine use, and escalating violent incidents as factors leading up to hostage-taking. Factors influencing lack of reporting incidents to law enforcement included having a criminal record, fear of partner retaliation, and intentions to terminate the relationship when the partner is incarcerated.
  
  
  CONCLUSIONS
  Educating women on the warning signs of hostage-taking within the context of methamphetamine use and promoting behaviour change among male perpetrators can contribute to reducing the risk of homicide. Furthermore, bridging the gap between health services and law enforcement agencies and providing comprehensive services that address the needs of methamphetamine-using women in violent relationships can prevent or minimize potential harm to vulnerable women.
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0849, La Jolla, CA 92093-0849, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Ludwig-Barron
authors.affiliation: Department of Anthropology, The Ohio State University, 4046 Smith Laboratory, 174 W. 18th Avenue, Columbus, OH 43210, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Syvertsen
authors.affiliation: Graduate School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92115, USA.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Lagare
authors.affiliation: School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA 90089-0411, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Palinkas
authors.affiliation: Division of Global Public Health, Department of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0849, La Jolla, CA 92093-0849, USA. Electronic address: jstockman@ucsd.edu.
authors.forename: Jamila K
authors.initials: JK
authors.lastname: Stockman
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D002140:California; D005260:Female; D006708:Homicide / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D000066511:Intimate Partner Violence / Q000523:psychology / Q000706:statistics & numerical data*; D007578:Jealousy; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage*; D008875:Middle Aged; D011329:Prisoners / Q000523:psychology / Q000706:statistics & numerical data*; D012725:Sexual Behavior
chemical_list: D008694:Methamphetamine
keywords: Femicide; Hostage; Methamphetamine; Partner violence; United States; Women