Inability to access health and social services associated with mental health among people who inject drugs in a Canadian setting

被引：32

作者：

Wang, Linwei ^{[1
]}

Panagiotoglou, Dimitra ^{[1
]}

Min, Jeong Eun ^{[1
]}

DeBeck, Kora ^{[1
,2
]}

Milloy, M. J. ^{[1
,3
]}

Kerr, Thomas ^{[1
,3
,4
]}

Hayashi, Kanna ^{[1
,3
]}

Nosyk, Bohdan ^{[1
,5
]}

机构：

[1] BC Ctr Excellence HIV AIDS, 608-1081 Burrard St, Vancouver, BC V6T 1Y6, Canada

[2] Simon Fraser Univ, Harbour Ctr, Sch Publ Policy, 515 West Hastings St, Vancouver, BC V6B 5K3, Canada

[3] Univ British Columbia, Dept Med, 2775 Laurel St, Vancouver, BC V5Z 1M9, Canada

[4] Univ British Columbia, Sch Populat & Publ Hlth, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

[5] Simon Fraser Univ, Fac Hlth Sci, Blusson Hall,8888 Univ Dr, Burnaby, BC V5A 1S6, Canada

来源：

DRUG AND ALCOHOL DEPENDENCE | 2016年 / 168卷

基金：

美国国家卫生研究院; 加拿大健康研究院;

关键词：

Service access; Comorbidity; Drug use; Mental health conditions; HIV; HCV; C VIRUS-INFECTION; STREET-INVOLVED YOUTH; ADDICTION TREATMENT; BRITISH-COLUMBIA; HIV-INFECTION; CARE SERVICES; SUBSTANCE USE; HEPATITIS; USERS; BARRIERS;

D O I：

10.1016/j.drugalcdep.2016.08.631

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: People who inject drugs (PWID) face barriers to healthcare due to reasons including comorbidity. We evaluated access to health and social services by three of the most prevalent comorbid conditions among PWID: HIV, hepatitis C (HCV), and mental health, in an urban setting in Canada. Methods: Data were derived from prospective cohorts of community-recruited PWID between 2005 and 2015. HIV and HCV serostatuses were based on antibody tests, while mental health conditions and inability to access health and social services (barriers to access) were determined by participants' self-report. We employed generalized linear mixed models controlling for confounders to examine associations between health conditions and barriers to access. Results: Among 2494 participants, 1632 (65.4%) reported barriers to access at least once over a median of seven (IQR: 3, 12) semi-annual assessments. Mental health conditions were independently associated with increased odds of reporting barriers (adjusted Odds Ratio (aOR): 1.45, 95% Confidence Interval (CI): 1.32,1.58), while HIV was not (aOR: 0.96, 95% CI: 0.85,1.08), and HCV was associated with decreased odds (aOR: 0.80, 95% CI: 0.69, 0.93). The associations between mental health conditions and barriers to access were consistent among PWID without HIV/HCV (aOR: 1.35, 95% CI: 1.10, 1.65), with HCV mono-infection (aOR: 1.55, 95% CI: 1.37, 1.75), and HCV/HIV co-infection (aOR: 1.36, 95% CI: 1.15, 1.60). Conclusions: Targeted strategies to seek and treat mental health conditions in settings that serve PWID, and assist PWID with mental health conditions in navigating healthcare system may improve the publicly funded health and social services. (C) 2016 Published by Elsevier Ireland Ltd.

引用

页码：22 / 29

页数：8