"I was like a rose, now I look like a thorn" An exploratory study of women injecting drug users (WIDU) in Tunisia

Abstract:

Aim: The aim of this master thesis was to explore contexts of initiation of substance use and to describe the social, physical and mental health situation of women injecting drug users (WIDU) in Tunisia.

Relevance: In North Africa, people who inject drugs are an important risk group in the HIV epidemic. There is evidence that WIDU are even more vulnerable. However, in Arabic Muslim societies, rehabilitation, treatment for this subpopulation and research on this issue are scarce.

Method: A qualitative study was conducted. Six in-depth interviews with WIDU in Tunis were recorded, transcribed and inductivelyanalyzed using thematic analysis.

Findings: Four themes were identified. The first theme describes situation of women before dependence. Women were brought up within patriarchal cultural norms where they were victimized. The second theme is related to the circumstances of initiation of drug use characterized by the wish for escape and pursue of pleasures. The third theme describes the dependence, withdrawal and consequences on everyday life. Final and fourth theme is related to the way out of addiction.

Conclusion and recommendations: The socio-ecological model and the gender relational theory helped to interpret the findings.WIDU in Tunisia suffer from marginalization and from social and health inequalities due to their gender and to their dependence. This puts them at a higher risk of violence, abuse, health hazards and blood-borne and HIV infections. Thus, awareness and policies should be designed in order to alleviate the stigma and bring services closer to this subpopulation.