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Addiction and Social Justice: Global and Local

January 26, 2016

Addiction and Social Justice: Global and Local

Jennifer Syvertsen.

Jennifer Syvertsen, assistant professor of anthropology, is developing complimentary global and domestic lines of research that address prescient questions of drug addiction, social inequalities and related health harms.

“In Kisumu, Western Kenya, my ethnographic research examines how the emergence of injection drug use shapes the region’s enormous HIV epidemic,” said Syvertsen. “While HIV incidence has been declining throughout the rest of Kenya, drugs and alcohol may be contributing to Kisumu County’s unabated epidemic where HIV prevalence reaches 18 percent in the general population. In this region, rapid urbanization and unequal distribution of wealth and opportunities are changing the social landscape.”

Syvertsen’s research reveals a drug market fueled by disaffected and bored youth who readily turn to drugs and engage in risky injection practices that heighten their vulnerability to HIV. As her team continues to examine questions about how gender and structural vulnerability shape patterns of drug-related harm, she is also extending this line of inquiry.

With support from a seed grant funded through the Department of Women’s, Gender and Sexuality Studies, Syvertsen recently completed a qualitative study on the reproductive health of women who inject drugs. And in new research, supported by a seed grant from Ohio State's Institute for Population Research, she will document the syndemic (a convergence of mutually reinforcing health epidemics exacerbated by structural and social vulnerabilities) of substance abuse, violence and HIV/sexually transmitted infections among female sex workers in Kisumu.

Syvertsen also plans, through qualitative interviews with patients and health care providers, to examine the cascade of care for newly enrolling HIV-positive patients in East Africa and, in particular, how mental health and substance abuse interferes with that cascade. She would work with an interdisciplinary research team of physicians and public health experts to ensure that patient and provider experiences are incorporated into meaningful medical practice. This study would connect Ohio State with the International Epidemiologic Databases to Evaluate AIDS (IeDEA) and further the university’s engagement with global HIV research.

“Given the gravity of the HIV epidemic in Kenya, this research has clear applied dimensions,” explained Syvertsen. “Our formative work helped provide the evidence needed at the national level to advocate for a needle-exchange program in Western Kenya, the first in the region. Our proposed work in a clinical setting also has the potential to improve care and service delivery to a diverse cross section of patients.”

Jennifer Syvertsen with a local clinic in Kisumu Kenya.
Syvertsen hopes that this research will lead to fruitful opportunities to build research capacity among young Kenyan scientists and opportunities for Ohio State students to see the contributions that anthropologists make to global health research.

She is also conducting research in Ohio: Together with colleagues from the Ohio State’s College of Social Work, Syvertsen is conducting qualitative interviews with health care providers and women to better understand adverse reproductive health outcomes among women struggling with addiction.

“Pregnant women and those with newborns tell us that navigating health and social service systems and the uncertainty surrounding diagnosis and treatment takes an emotional toll,” said Syvertsen. “Further, the experiences of many of these women contrast with stereotypes of the 'selfish addict mother' and raise questions about how gender, stigma and notions of “deservingness” shape women’s chances for a healthy life for themselves and their families."

Syvertsen is working to expand this line of inquiry to examine opiate use in the broader population, including reported outbreaks of hepatitis C and the risk for HIV to spread into new areas of Ohio.

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