Drugs and Diet among Women Street Sex Workers and Injection Drug Users in Quebec City

Article excerpt

Abstract

This study aims to describe the dietary profile of women both street sex workers and injection drug users in Quebec City (Canada) and to explore the role of injection drug use on the determinants of their diet. A convenient sample of twenty-one women was recruited from June to September 2008. Data were obtained through one 24-hour recall interviews followed by semi-structured individual interviews. Dietary profile indicated not only low (on average, 3.8 servings of Vegetables and Fruits, 3.2 servings of Grain Products, 1.2 servings of Milk and Alternatives, 1.2 servings of Meat and Alternatives) but also poor dietary intake according to Canadas Food Guide. Semi-structured interviews suggest that drug use caused appetite loss, health problems, psychological problems, poor dietary practices and addiction that reduce food intake. Participants also reported strong preferences for sweets and alcoholic drinks. These women endured inadequate dietary intake. Dietary interventions specific to their reality are warranted.

Keywords: Sex work, injection drug use, dietary intake, determinants of healthy eating, women

Resume

Cette etude vise a decrire le profil alimentaire des femmes a la fois travailleuses du sexe de rue et utilisatrices de drogues par injection a Quebec et a explorer le role de l'injection des drogues sur les determinants de leur alimentation. Les donnees ont ete recueillies aupres de 21 femmes a l'aide d'un rappel de 24 heures suivi d'entrevues individuelles semi-structurees. Leur profil alimentaire signale un apport alimentaire inadequat tant en quantite (en moyenne 3,8 portions de Legumes et fruits, 3,2 de Produits cerealiers, 1,2 de Lait et substituts, 1,2 de Viandes et substituts) qu'en qualite selon le Guide alimentaire canadien. D'apres les entrevues semi-structurees, l'usage des drogues entrainerait la perte d'appetit, des problemes de sante, des difficultes psychologiques, la toxicomanie et des pratiques alimentaires inappropriees reduisant l'apport alimentaire. De fortes preferences pour les aliments sucres et les boissons alcoolisees affecteraient aussi la qualite de leur alimentation. Des interventions specifiques a la realite de ces femmes sont indispensables.

Mots cles : Travail du sexe de rue, injection de drogues, apport alimentaire, determinants de l'alimentation saine, femmes

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Sex work generally refers to women (Plamondon et al. 2002) because they are more numerous than men in this line of work (Fournier 2004). It is expressed in several forms including street sex work which is considered the most visible and disturbing (Damant et al. 2006). Street sex work, a form of prostitution carried out in public, is a prohibited practice in Canada and offenders are liable to sanctions. Hence, women who engage in this activity are vulnerable to police repression and violence (Bedard et al. 2009). They are generally grouped in the inner city and face multiple challenges including lack of access to basic services (Brown et al. 2006).

Women street sex workers are often addicted to injection drug use (Bertrand et Nadeau 2006) which is a major public health problem (Roy et al. 2006). Indeed, this is the most dangerous form of drug use given the numerous risks ir represents (Poole and Dell 2005). Ir leads to many social, sanitary, nutritional problems and increased risk of mortality (Health Canada 2001).

The risk of malnutrition is known to be present among drug addicts (Gomez-Sirvent et al. 1993; Santolaria-Fernandez et al. 1995; Himmelgreen et al. 1998; Islam et al. 2002). Studies mainly associate poor nutritional status with major changes in food and liquid intake behavior modulated by drug use (Mohs, Watson and Leonard-Green 1990; Nolan and Scagnelli 2007). Indeed, drug users' diet is precarious (Himmelgreen et al. 1998). Low dietary intake of fruits, vegetables and grain products, and high intake of sugar and alcohol would be common (Morabia et al. …