{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:49:35Z","timestamp":1782845375239,"version":"3.54.5"},"reference-count":68,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"\n Background<\/jats:title>\n HIV risk behavior in women who use drugs is related to myriad psychosocial issues, including incarceration. The experience of incarceration elevates women\u2019s HIV risk by disrupting social networks, housing, employment, and access to health care. During the COVID-19 pandemic, changes in criminal-legal practices resulted in decreased incarceration, especially among women. These changes may have largely altered HIV risk among women who use drugs, depending on their access to care in the community.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study seeks to build knowledge about the impact of shifts in criminal-legal practices during the COVID-19 pandemic on HIV risk behaviors of justice-involved women who use drugs.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Qualitative methods are used to gather and analyze women\u2019s narratives about their life experiences before and during the COVID-19 pandemic, with a focus on individual and structural determinants of HIV risk behaviors. Thirty formerly incarcerated women with a history of substance use are being recruited through collaboration with community partners. Each participant completes a sociodemographic survey and two interviews. The first interview uses a life history instrument that invites participants to reflect on key turning points in their lives. The second interview uses a calendar approach to gather information about participants\u2019 lives during the first year of the COVID-19 pandemic (March 2020-March 2021). The interviews (1 hour each) are audio-recorded and transcribed for analysis. Rapid Qualitative Inquiry and thematic analysis are being used to manage, organize, and interpret the data. The study team will collaborate with a subset of participants to develop digital stories about their COVID-19 experiences, a process that allows for member-checking and triangulation. Findings will be disseminated to program and policy makers in academic venues, community settings, and social service agencies.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n To date, 10 women\u2019s data have been collected. In total, two themes have been identified in this preliminary data: (1)the chaos and instability of participants\u2019 lives increased during the COVID-19 pandemic: participants reported a wide range of psychosocial and health problems and limited engagement with social service systems. Interaction with criminal-legal systems was rife with uncertainty; participants described living in a state of limbo, which was extremely stressful. (2) When asked to describe a \u201cturning point\u201d in their lives, many participants attributed their substance use to the traumatic loss of a child due to death, incarceration, or termination of parental rights. During the COVID-19 pandemic, participants\u2019 struggles to cope with these unresolved experiences of grief and loss were intensified by the widespread death and dying of the pandemic.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Preliminary findings suggest that HIV risk factors increased for participants during the COVID-19 pandemic and invite further investment in community-based harm reduction programs, especially housing, that support women who use drugs. Interventions that address experiences of maternal grief and loss may reduce women\u2019s substance use.<\/jats:p>\n <\/jats:sec>\n \n International Registered Report Identifier (IRRID)<\/jats:title>\n DERR1-10.2196\/58285<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/58285","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T11:15:22Z","timestamp":1727694922000},"page":"e58285","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Changes in Criminal-Legal Practices During the COVID-19 Pandemic on the HIV Risk Behaviors of Women Who Use Drugs: Protocol for a Multimethods Qualitative Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6665-5945","authenticated-orcid":false,"given":"Amy B","family":"Smoyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"ref1","unstructured":"Fast facts: HIV and women2022-10-29Centers for Disease Control and Preventionhttps:\/\/www.cdc.gov\/hiv\/data-research\/facts-stats\/women.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/hiv\/group\/gender\/women\/incidence.html"},{"key":"ref2","unstructured":"HIV and women: HIV diagnosis. 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