Violence against women (VAW) is a significant public health and human rights issue, with an estimated 736 million women globally experiencing VAW. Consistent evidence demonstrates that substance use is associated with VAW and that participation in substance use treatment programs is associated with reduction in substance use-related violence. While evidence demonstrates the ability to address VAW through substance use treatment programs, less attention has been paid to geographic access to substance use programs. If these programs are geographically inaccessible, particularly to marginalized populations, many people will not get the help they need. This study seeks to explore the relationship between geographic access to substance use treatment programs on VAW. Using data from the HIV Prevention Trials Network (HPTN) 064 study, longitudinal multilevel models were used to assess the relationship between neighborhood-level social determinants, with a specific focus on geographic access to Substance Abuse and Mental Health Services Administration (SAMHSA) certified drug and alcohol treatment programs and VAW. The study included 1910 women, ages 18 to 44, living in select geographic areas with high-ranked prevalence of HIV and poverty. The findings of this study indicate that among women who reside in census tracts with high prevalence rates of HIV: (1) substance use increases VAW; (2) VAW decreases as geographic access to SAMHSA-certified drug and alcohol treatment facilities increases; and (3) when looking at specific types of VAW, emotional and physical abuse decreases as geographic access to substance use treatment increases. Policies and programs to increase access to substance use treatment should be explored and evaluated, and more programs are needed that address the intersectionality of substance use and VAW.

中文翻译：

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药物使用治疗计划的地理获取和针对妇女的暴力行为的探索

针对妇女的暴力行为 (VAW) 是一个重大的公共卫生和人权问题，全球估计有 7.36 亿女性遭受过 VAW 侵害。一致的证据表明，药物使用与暴力侵害妇女行为有关，参与药物使用治疗计划与药物使用相关暴力的减少有关。虽然有证据表明通过药物使用治疗计划能够解决暴力侵害妇女问题，但人们很少关注药物使用计划的地理获取情况。如果这些项目在地理位置上难以获得，特别是对于边缘化人群来说，许多人将无法获得所需的帮助。本研究旨在探讨针对 VAW 的物质使用治疗计划的地理获取情况之间的关系。利用艾滋病毒预防试验网络 (HPTN) 064 研究的数据，纵向多级模型用于评估社区级社会决定因素之间的关系，特别关注药物滥用和心理健康服务管理局 (SAMHSA) 认证药物的地理获取情况酒精治疗计划和暴力侵害妇女行为。该研究纳入了 1910 名年龄在 18 岁至 44 岁之间的女性，她们生活在艾滋病毒流行率和贫困率较高的特定地理区域。本研究的结果表明，居住在艾滋病毒流行率高的人口普查区的妇女中：(1) 物质使用增加了暴力侵害妇女行为； (2) 随着 SAMHSA 认证的戒毒和酗酒治疗机构的地理覆盖范围的增加，暴力侵害妇女行为减少； (3) 当考虑特定类型的暴力侵害妇女行为时，随着获得药物滥用治疗的地理范围的增加，情感和身体虐​​待会减少。应探索和评估增加获得药物滥用治疗机会的政策和计划，并且需要更多计划来解决药物滥用和暴力侵害妇女行为的交叉问题。