Navigating the Risk Environment: Structural Vulnerability, Sex, and Reciprocity among Women Who Use Meth

Drug users’ risky sexual practices contribute to their increased risk for contracting HIV and other sexually transmitted infections. Use of methamphetamine has been associated with a number of high-risk sexual practices such as frequent sexual contacts, multiple sex partners, unprotected sex, and exchange sex. The media construct women who use meth as engaging in exchange sex to support their drug habit. Despite an abundance of data on exchange sex among heroin and crack users that suggest the importance of examining these practices in context, they remain understudied among female methamphetamine users. 

This article draws on preliminary findings from ongoing ethnography with female meth users to highlight the risk environment(s) that contribute to structural vulnerability and shape behaviour. While their sexual practices may be deemed transactional and risky, understanding their embeddedness in structural context and networks of reciprocity is essential to understanding implications for policy and harm reduction.

...With one exception, all of the women in this study identified as “meth users” or “meth addicts”; on average, they used over a gram of meth per day and 18 days per month. While more than half of the women did use other drugs (see Table 1), the vast majority viewed meth as their “drug of choice”. All of the women lived in economically precarious circumstances, depending on a combination of hustling, short-term licit and illicit employment, reciprocal relationships, and government assistance. Only four had steady work in the past year and most were housing insecure. Many had criminal records resulting from drug use and poverty; the drug possession charges were especially detrimental, affecting women’s eligibility for housing as well as employment. While exchange sex was not a common survival or drug acquisition strategy for these women, dependence upon the moral economy was...

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By: Stacey A. McKennaa

aUniversity of Colorado Denver, Department of Health & Behavioural Sciences, Campus Box 188, PO Box 173364, Denver, CO 80217-3364