Double Vulnerability: A Qualitative Analysis Of Barriers To Help-Seeking And Experiences Of Partner Violence Among Stimulant-Using Women With Disabilities

Statement of purpose Women with disabilities are disproportionately affected by physical and sexual partner violence (PV) and are at increased risk for substance misuse and dependency. While several studies highlight the relationship between PV among women with disabilities, the role of substance use remains understudied. We sought to qualitatively characterise experiences of PV among stimulant-using women with disabilities and barriers to help-seeking. Methods Our mixed Methods study aimed to capture lethality risk, relationship dynamics and safety planning among women aged u003e18 years, engaging in stimulant use (i.e., methamphetamine, cocaine, and crack), experiencing physical/sexual violence by a current male partner and residing in San Diego, CA. Emergent themes surrounding disability-specific violence were explored through thematic analysis among women reporting disability benefits. Results Women receiving disability benefits (n = 10) were on average 53 years old (range 44–62). Seventy percent reported poly drug use, 60% ever injected drugs, and 80% had a current drug-using partner. Over half (60%) reported forced sex by partners within the last year and 80% were at high risk for lethality. All women described dependence on their partner for basic needs, social support or drugs. Violent triggers included drug withdrawal symptoms, watching pornography, noncompliance to sexual requests, and withholding money. Barriers to help-seeking included fear of being misunderstood, prior drug convictions, loss of independence and companionship by terminating relationship, isolation, and fear of losing privileges (e.g., SSI/SSDI, child visitation). Conclusions Findings indicate stimulant-using women with disabilities face additional barriers to help-seeking that are specifically tied to their disability and substance use. Accounts of violent triggers can help inform programs and services dedicated to educating women with disabilities on the warning signs of potential lethality. Significance and contributions Our study points to specific barriers to help-seeking and highlights the need for additional integrated services for stimulant-using women with disabilities experiencing PV.