Navigating drug use, cessation, and recovery: a retrospective case notes review among sexual minority men at a community-based service in Singapore.

BACKGROUND: In Singapore, where drug use is a highly stigmatized and criminalized issue, there is limited understanding of the challenges faced by individuals, particularly sexual minority men, in their journey towards recovery from substance dependence or addiction. This qualitative study aimed to investigate the driving forces behind drug use, the factors contributing to drug cessation, and the elements influencing the recovery process. METHODS: Data were extracted from clinical records provided by  The Greenhouse Community Services Limited between January 2020 to May 2022. These records encompassed information from four distinct forms: the intake assessment, progress notes, case closing summary, and the care plan review. Thematic analysis was employed to identify and categorize recurring themes within the data. RESULTS: Data from beneficiaries (n = 125) were analyzed and yielded a series of themes related to facilitators of drug use, motivations to cease drug use, and managing one's ongoing recovery. Within the facilitators of drug use, two sub-themes were identified: (a) addressing trauma and triggers and (b) managing emotions. Additionally, managing one's recovery was marked by four significant sub-themes: (a) uncovering personal identities, (b) losing motivation and drive, (c) overcoming obstacles, and (d) preparing for aftercare. CONCLUSIONS: The study contributes valuable insights into the dynamics of ongoing recovery management, offering potential avenues for interventions that could enhance support for individuals in their journey to overcome substance dependence. Enhancing psychoeducation and fostering peer support have the potential to facilitate the recovery process. Clearly, a holistic approach is needed to address these complex issues that cuts across our societies.

"Females are always dominated and disregarded by males, just because they are female": the continuation of patriarchal norms for young trafficked women in Nepal.

This article provides insights into the cultural aspects of sexual violence against young women trafficked into the sex industry in Nepal. Participant observation, participatory clay body mapping workshops and group interviews using photography were used to explore the reproductive body of six formerly trafficked women aged 14-22 years. Intimate partner violence against women, domestic violence and violence against women were important issues raised during the research process. Societal and familial patriarchal norms are the root causes of violence against women in Nepal and can be traced back to the Hindu legal code, the Muluki Ain of 1854, which was enforced for over 100 hundred years. Our findings indicate that tackling violence against women is complex for Nepali trafficked women because of its multiple forms and sources.

Multiplicity of stigma: the experiences, fears and knowledge of young trafficked women in Nepal.

We undertook a reproductive health study on young formerly trafficked women in Nepal using a new research method - the Clay Embodiment Research Method - designed with their vulnerability and the cultural context in mind. Following a two-month period of participant observation, six formerly trafficked women participated in a series of seven themed (clay embodiment/three-dimensional body mapping) workshops and, afterward, a group interview using photoethnography. We discovered that these women are subject to cultural stigmas other than those related to sex trafficking, such as menstrual stigma, stigma related to pre-marital sex, stigma related to pregnancy before marriage and stigma for having a female child. These can have a deep impact across the entire reproductive lives of women. As a cultural force, the stigmatisation is generated by both men and women, and has roots that lie in Hinduism and the patriarchal value system in Nepal. Nepal is attempting to address some of these issues and we recommend a public health campaign to eliminate the practice of the menstruation and other stigmatising traditions.