Housing instability and violence among women who use drugs in Dar es Salaam, Tanzania

Claire Silberg; Samuel Likindikoki; Jessie Mbwambo; Kristin Mmari; Haneefa T Saleem

doi:10.1186/s12954-022-00649-x

Housing instability and violence among women who use drugs in Dar es Salaam, Tanzania

Harm Reduct J. 2022 Jun 27;19(1):68. doi: 10.1186/s12954-022-00649-x.

Authors

Claire Silberg¹, Samuel Likindikoki^{2

3}, Jessie Mbwambo³, Kristin Mmari¹, Haneefa T Saleem⁴

Affiliations

¹ Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD, 21205, USA.
² Department of Epidemiology and Biostatistics, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65015, Dar es Salaam, Tanzania.
³ Department of Psychiatry and Mental Health, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
⁴ Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Room E5033, Baltimore, MD, 21205, USA. haneefa.saleem@jhu.edu.

Abstract

Background: Women who use heroin and other drugs (WWUD) are a key population with elevated risk of physical and sexual violence perpetrated by intimate partners and non-partners. While housing instability has been shown to be associated with violence in high-income settings, this is an underexplored topic in sub-Saharan Africa. In this research, we aimed to assess the relationship between housing instability and various forms of violence within a sample of WWUD in Dar es Salaam.

Methods: This analysis uses data from a parent study from 2018. A total of 200 WWUD were recruited through respondent-driven sampling methods and administered a survey. Two multivariable logistic regression models were built to assess the relationship between housing instability and physical violence (Model 1) and housing instability and sexual violence (Model 2) while controlling for a number of sociodemographic characteristics.

Results: Approximately 35% of participants were classified as housing unstable. More than half of participants (62%) reported experiencing physical violence in the past 12 months, and more than a third (36%) reported sexual violence in the same time period. Housing instability was found to be independently associated with both physical and sexual violence victimization in the past year when adjusting for covariates (Model 1 adjusted odds ratio [AOR]: 2.40, 95% CI 1.22-4.46; Model 2 AOR: 1.93. 95% CI 1.02-3.67).

Conclusion: To our knowledge, this is the first study to document a significant association between housing instability and violence among WWUD communities in sub-Saharan Africa. This analysis adds to the growing body of literature on the relationship between stable housing and livelihood and health outcomes across differing populations. The cyclical nature of housing instability and violence may be disrupted through housing programming that provides safety, security, and stability for WWUD.

Keywords: Housing instability; Opioids; Tanzania; Violence against women; Women who use drugs.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Female
Housing Instability*
Humans
Sex Offenses*
Sexual Partners
Tanzania / epidemiology
Violence

Abstract

Publication types

MeSH terms

Grants and funding