Background—The role of relationships in initiating and maintaining women’s risk behaviors has been established. However, understanding factors that may underlie partner relationships and women’s risky drug use, particularly in rural contexts, is limited. This study is the first to examine the association between injecting partners and women’s risky injection practices as a function of relationship power perception.

Methods—Female participants were recruited from three rural jails in the Appalachian region. Women were randomly selected, provided informed consent, and screened for study eligibility criteria. This cross-sectional analysis focuses on women who inject drugs (WWID) during the year before entering jail (n=199).

Main findings—Approximately three-quarters (76%) reported having a recent main male sexual partner with a history of injection drug use (IDU). Although having a risky partner independently increased the likelihood of women reporting shared injection practices, perceptions of relationship power significantly moderated the effect on shared needle (AOR = 0.02 [0.003, 0.23]; p = .001) and shared works (AOR = 0.17 [0.03, 0.95]; p = .04) use.

Conclusions—This interaction indicated that for WWID with a recent injecting male partner, greater perception of relationship power was associated with a decreased likelihood of shared injection practices. Implications for clinical assessment and intervention are discussed.

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Notes/Citation Information

Published in Women's Health Issues, v. 27, issue 6, p. 652-659.

© 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc.

This manuscript version is made available under the CC‐BY‐NC‐ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/.

The document available for download is the authors’ post-peer-review final draft of the article. Its title is “Partner relationships and high-risk practices among rural Appalachian women who inject drugs.”

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Funding Information

This work was supported by the National Institute on Drug Abuse/National Institutes of Health under Awards R01DA033866 and K02DA035116.