Notwithstanding the different perceptions of what constitutes violence in the context of police forcing women who inject drugs to have sex with them, women (including sex workers) who have endured police sexual violence experience it as an unbearable trauma. The power imbalance between police and women seems so drastic that women who inject drugs and those who serve them hardly see any solution to the problem. This CSO representative’s account also reflects the secondary trauma to the people witnessing the trauma when she recalls: After hearing what those sex workers told me [about the police violence they had been exposed to], I wanted to switch off my head. For six hours I just lay in my bed, I couldn’t move. It’s . . . indigestible, you know? You can’t imagine how it happens on an everyday basis. How these women are totally, absolutely powerless. They understand they can be killed, they can be raped, they can be abused in any possible way by the police officers, and nobody can protect them. Nobody can do it, you know? Female CSO staff #DiscussionThis study documents a high prevalence (24 ) of sexual violence from police in a cross-sectional analysis of a cohort of Russian HIV-positive women who inject drugs. Gender-based violence against women is a global public health problem. It is a criminal justice issue and has far reaching health impact beyond immediate trauma [17]. A recent review of sexual violence globally found that more than 7 of women have ever experienced non-partner sexual violence, with a prevalence of 6.9 in Eastern Europe [18]. The proportion of women having experienced sexual violence from police in this study (24 ) represents over three times the regional rate of non-partner sexual violence against women (which is not limited to police). This indicates an epidemic of sexual violence against HIV-positive women who inject drugs perpetrated by law enforcement. This study found that women who report sexual violence from police have higher rates of punitive police involvement such as arrests and planted evidence. Sexual violence from police against women who inject drugs is associated with the risk of more frequent injections, suggesting that oppressive policing adds to the risk environment. Sexual violence is both a criminal and human rights violation. Among PWID, it carries many HIV and health risks. Due to its cross-sectional design, our study cannot infer any causality or direction of causality between violence and risk behaviours. While sexual violence from police could increase affected women’s risk behaviours, the inverse might also be the case: women who are, obvious to police, using drugs and RR6 supplier engaging in risky NIK333MedChemExpress NIK333 behaviours might be more vulnerable to their abuse and even sexual violence than those whom they do not perceive as drug users. A study conducted in Vancouver, Canada, found that PWID who experienced sexual violence in their lives were more likely to become infected with HIV, be involved in transactional sex, share needles, attempt suicide and experience an overdose [19]. The quantitative study showed that trading sex for drugs or money is not associated with women’s risk of sexualviolence from police. However, sexual violence from police is not limited to women who sell sex for drugs or money, albeit they are particularly vulnerable [20]. Notably the majority of women affected by sexual violence from police in our study did not report a history of sex trade. The qualitative data indicate that the sexua.Notwithstanding the different perceptions of what constitutes violence in the context of police forcing women who inject drugs to have sex with them, women (including sex workers) who have endured police sexual violence experience it as an unbearable trauma. The power imbalance between police and women seems so drastic that women who inject drugs and those who serve them hardly see any solution to the problem. This CSO representative’s account also reflects the secondary trauma to the people witnessing the trauma when she recalls: After hearing what those sex workers told me [about the police violence they had been exposed to], I wanted to switch off my head. For six hours I just lay in my bed, I couldn’t move. It’s . . . indigestible, you know? You can’t imagine how it happens on an everyday basis. How these women are totally, absolutely powerless. They understand they can be killed, they can be raped, they can be abused in any possible way by the police officers, and nobody can protect them. Nobody can do it, you know? Female CSO staff #DiscussionThis study documents a high prevalence (24 ) of sexual violence from police in a cross-sectional analysis of a cohort of Russian HIV-positive women who inject drugs. Gender-based violence against women is a global public health problem. It is a criminal justice issue and has far reaching health impact beyond immediate trauma [17]. A recent review of sexual violence globally found that more than 7 of women have ever experienced non-partner sexual violence, with a prevalence of 6.9 in Eastern Europe [18]. The proportion of women having experienced sexual violence from police in this study (24 ) represents over three times the regional rate of non-partner sexual violence against women (which is not limited to police). This indicates an epidemic of sexual violence against HIV-positive women who inject drugs perpetrated by law enforcement. This study found that women who report sexual violence from police have higher rates of punitive police involvement such as arrests and planted evidence. Sexual violence from police against women who inject drugs is associated with the risk of more frequent injections, suggesting that oppressive policing adds to the risk environment. Sexual violence is both a criminal and human rights violation. Among PWID, it carries many HIV and health risks. Due to its cross-sectional design, our study cannot infer any causality or direction of causality between violence and risk behaviours. While sexual violence from police could increase affected women’s risk behaviours, the inverse might also be the case: women who are, obvious to police, using drugs and engaging in risky behaviours might be more vulnerable to their abuse and even sexual violence than those whom they do not perceive as drug users. A study conducted in Vancouver, Canada, found that PWID who experienced sexual violence in their lives were more likely to become infected with HIV, be involved in transactional sex, share needles, attempt suicide and experience an overdose [19]. The quantitative study showed that trading sex for drugs or money is not associated with women’s risk of sexualviolence from police. However, sexual violence from police is not limited to women who sell sex for drugs or money, albeit they are particularly vulnerable [20]. Notably the majority of women affected by sexual violence from police in our study did not report a history of sex trade. The qualitative data indicate that the sexua.
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