{"doi":"10.1371/journal.pone.0303378","title":"A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs","abstract":"BACKGROUND: Domains of adequate menstrual health (MH) include access to water, sanitation, and hygiene (WASH). People who menstruate with social disadvantages-such as homelessness or drug injection practices-often face barriers to WASH access. However, validated instruments to measure MH are limited among marginalized populations, and available instruments involve lengthy surveys. We developed and evaluated psychometric properties of a novel 'MH WASH Domain Scale-12' among people who menstruate and who inject drugs in the Tijuana-San Diego region and identified correlates of MH access using this scale. METHODS: We constructed a MH-scale based on access to twelve WASH-related items: (1) menstrual products, (2) body hygiene (bathing per week), (3) water sources for bathing, (4) improved, (5) non-shared, (6) available, (7) private, (8) nearby, (9) and safe sanitation facilities, (10) availability of soap, (11) water source for handwashing, and (12) handwashing facilities with soap/water. Variables were dichotomized and summed, with scores ranging from 0-12 points and higher scores indicating better MH access. We assessed the scale's reliability and construct and content validity using data from a binational cross-sectional study. The sample included people who inject drugs (PWID) who had ever menstruated in their lifetime and were 18+ during 2020-2021. MH-WASH items were described, and the scale was further used as an outcome variable to identify correlates. RESULTS: Among 125 (124 cis-female and 1 trans-male) PWID that reported menstruating, our 'MH WASH Domain Scale-12' was reliable (Cronbach's alpha = 0.81, McDonald's Omega total = 0.83) and valid. We identified two sub-domains: Factor-1 included items describing 'WASH availability' and Factor-2 contained items related to 'WASH security'-encompassing physical and biological safety. Scale scores were significantly lower among participants experiencing unsheltered homelessness compared to participants experiencing sheltered homelessness or living in permanent housing. CONCLUSION: We constructed and validated a novel and reliable scale to measure MH-related WASH access that can be used to assess MH among marginalized populations in English- and Spanish-speaking contexts. Using this scale we identified disparities in MH-WASH access among PWID and who menstruate in the US-Mexico border region.","journal":"PLoS ONE","year":2024,"id":459512,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":4,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9533,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1029711,"name":"Lourdes Johanna Avelar Portillo","orcid":"0000-0001-7502-7273","position":1,"is_corresponding":false},{"id":666151,"name":"Daniela Abramovitz","orcid":"0000-0002-2969-7193","position":2,"is_corresponding":false},{"id":371948,"name":"Shira M. Goldenberg","orcid":"0000-0003-1633-9749","position":3,"is_corresponding":false},{"id":1286620,"name":"Shawn Teresa Flanigan","orcid":"0000-0002-9502-9839","position":4,"is_corresponding":false},{"id":356986,"name":"Penelope J E Quintana","orcid":"0000-0003-0318-3714","position":5,"is_corresponding":false},{"id":516177,"name":"Alicia Vera","orcid":"0000-0002-8708-8169","position":6,"is_corresponding":false},{"id":667125,"name":"Carlos F. Vera","orcid":null,"position":7,"is_corresponding":false},{"id":409490,"name":"Gudelia Rangel","orcid":"0000-0003-3376-152X","position":8,"is_corresponding":false},{"id":301815,"name":"Steffanie A. Strathdee","orcid":"0000-0002-7724-691X","position":9,"is_corresponding":false},{"id":601954,"name":"Georgia Kayser","orcid":"0000-0002-3273-184X","position":10,"is_corresponding":false},{"id":308874,"name":"Alhelí Calderón-Villarreal","orcid":"0000-0003-1064-7097","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:03:59.428859Z","pmid":"38728343","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}