Psychosocial factors of sexual practices among women using heroin and other drugs: A systematic literature review

First published: 10 May 2019 | Last updated: 20 May 2019


Women using heroin and other drugs (WHOD) are at high risk of sexually transmitted infections (STIs) and blood-borne viruses (BBVs). However, little attention has been paid on those factors that have a role in the development and maintenance of women ‘s sexual behavior. This research aimed at identifying psychosocial factors of sexual practices, and providing evidence on the nature and quality of the available data.


The search strategy included five databases: PubMed, EMBASE, PsycNET, Web of Science and Scopus. PsycEXTRA was used for grey literature and other publications. Search terms included ‘women *’, ‘heroin use*’, ‘sexual behaviour*’, and ‘HIV””. The PRISMA 2009 guidelines was used for quality assessment purposes. This systematic review was registered with PROSPERO (Ref. CRD42016039842).


Out of the 12,135 publications screened, 30 peer-reviewed articles were included. Most publications were cross-sectional (n=25) quantitative studies (n=23), amounting 11,305 women. These were socio-demographic characteristics; alcohol and drug using patterns; gender roles and violence against women; partner type, partner characteristics and context of sex; number of partners; preferences, negotiation and availability of condoms; sex work; HIV status and other sexually transmitted diseases; risk awareness and perception of control; love and trust; pregnancy, fertility and motherhood. These findings were however inconsistent due to the heterogeneity of the samples, the varied methodologies used, and how the outcomes were measured.


Overall, this review highlights important implications for future research and practice, such as the need to focus on relationship dynamics, the role of emotions, and the study of the broader sociocultural context of sex and sexuality. It also provides evidence for the development of STI/BBV preventive strategies, and promotion of sexual health and psychosocial wellbeing of WHOD.

* The data of this research project will be presented orally at the STI & HIV World Congress in July 2017.


Dack C2, Family H1, Scott J1 & Barnett J2 1 Department of Pharmacy & Pharmacology, University of Bath (United Kingdom) 2 Department of Psychology, University of Bath (United Kingdom)

Conflicts of interest:

No conflict of interest.


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