Police-related barriers to harm reduction linked to non-fatal overdose amongst sex workers who use drugs: Results of a community-based cohort in Metro Vancouver, Canada

被引：43

作者：

Goldenberg, Shira ^{[1
,2
]}

Watt, Sarah ^{[1
,2
]}

Braschel, Melissa ^{[1
]}

Hayashi, Kanna ^{[2
,5
]}

Moreheart, Sarah ^{[1
]}

Shannon, Kate ^{[1
,3
,4
]}

机构：

[1] Ctr Gender & Sexual Hlth Equ, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

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

[3] Univ British Columbia, Sch Populat & Publ Hlth, 5804 Fairview Ave, Vancouver, BC V6T 1Z3, Canada

[4] Univ British Columbia, St Pauls Hosp, Dept Med, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

[5] BC Ctr Subst Use, 400-1045 Howe St, Vancouver, BC V6Z 2A9, Canada

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2020年 / 76卷

基金：

美国国家卫生研究院; 加拿大健康研究院;

关键词：

Sex work; Drug overdose; Harm reduction; Women; Policing; Criminalization; CRYSTAL METHAMPHETAMINE USE; HIV RISK; FENTANYL; WOMEN; PREVALENCE; CHALLENGES; PREVENTION; VIOLENCE; CLIENTS; HEROIN;

D O I：

10.1016/j.drugpo.2019.102618

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 - High rates of overdose and overdose-related mortality in North America represent a pressing health and social concern. Women sex workers face severe health and social inequities, which have been linked to structural factors including negative police interactions; however, little is known regarding the burden of overdose or how policing impacts overdose risk amongst sex workers who use drugs. Given this, we aimed to explore the independent effects of experiencing police-related barriers to harm reduction on non-fatal overdose amongst women sex workers who use drugs in Metro Vancouver, Canada over a 7.5-year period. Methods: Data were drawn from An Evaluation of Sex Workers Health Access (AESHA), a community-based open prospective cohort of women sex workers in Metro Vancouver, from 2010 to 2017. Using multivariate logistic regression with generalized estimating equations (GEE), we used a confounder modeling approach to identify the independent effect of experiencing police-related barriers to harm reduction strategies on non-fatal overdose amongst sex workers using drugs within the last six months at each study visit. Results: Amongst 624 participants, 7.7% overdosed within the last six months at baseline and 27.6% overdosed during the study period, contributing 287 non-fatal overdose events over the 7.5-year period. 68.6% reported police-related barriers to harm reduction strategies during the study. In a multivariate confounder model, exposure to police-related barriers to harm reduction strategies [AOR: 2.15, CI: 1.60-2.90] was independently associated with higher odds of non-fatal overdose after adjustment for key confounders. Conclusions: Our findings suggest that in the context of the current overdose crisis, adversarial policing practices may undermine access to lifesaving overdose prevention services and exacerbate overdose risks for marginalized women. Findings underscore the urgent need to scale-up access and remove barriers to progressive harm reduction strategies for women sex workers.

引用

页数：8

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