A qualitative study of service engagement and unmet needs among unstably housed people who inject drugs in Massachusetts

被引:3
作者
Hassan, Rashida [1 ,4 ]
Roland, Katherine B. [1 ]
Hernandez, Brenda [2 ]
Goldman, Linda [2 ]
Evans, Kimberly N. [1 ]
Gaul, Zaneta [1 ,3 ]
Agnew-Brune, Christine [1 ]
Buchacz, Kate [1 ]
Fukuda, H. Dawn [2 ]
机构
[1] CDCP, Atlanta, GA USA
[2] Massachusetts Dept Publ Hlth, Boston, MA USA
[3] ICF, Atlanta, GA USA
[4] MS US8-4 1600 Clifton Rd NE, Atlanta, GA 30329 USA
关键词
People who inject drugs; Substance-related disorders; Qualitative research; HIV; RISK BEHAVIORS; HOUSING; 1ST; OVERDOSE DEATHS; HIV DIAGNOSES; UNITED-STATES; HOMELESS; REDUCTION; PREVENTION; DEPRESSION; BALTIMORE;
D O I
10.1016/j.jsat.2022.108722
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Introduction: People who inject drugs (PWID) are disproportionately affected by HIV in the United States, and HIV prevention and care services may be inaccessible to or underutilized by PWID. In 2018, the Massachusetts Department of Public Health (MDPH) and the Centers for Disease Control and Prevention (CDC) investigated an increase in HIV diagnoses primarily among unstably housed PWID in Lawrence and Lowell.Methods: The response team interviewed 34 PWID in Lawrence and Lowell, with and without HIV, to inform effective response strategies. Qualitative interviews were recorded, transcribed, and coded. Interviews were transcribed verbatim and coded using a thematic analysis approach structured around pre-designated research questions related to service engagement (including harm reduction services, substance use disorder treatment, medical services, shelters, and other community services), unmet needs, and knowledge gaps regarding HIV prevention.Results: Participants ranged in age from 20 to 54 years (median: 32); 21 of the 34 participants (62%) were male, and 21 were non-Hispanic white. Fifteen (44%) self-reported being HIV positive. All 34 participants had experienced homelessness in the past 12 months, and 29 (85%) had ever received services at syringe service programs (SSP). We identified five key themes: substance use as a barrier to accessing health and social services; experiences of trauma and mental illness as factors impacting substance use and utilization of services; unstable housing as a barrier to accessing services; negative perceptions of medication for opioid use disorder (MOUD); and the desire to be treated with dignity and respect by others.Conclusions: Findings highlight the need for well-resourced and integrated or linked service provision for PWID, which includes mental health services, housing, MOUD, harm reduction, and infectious disease prevention and care services. Co-locating and integrating low-barrier services at trusted community locations, such as SSPs, could increase service engagement and improve health outcomes for PWID. Further implementation science research may aid the development of effective strategies for services for PWID and build trusting relationships between service providers and PWID.
引用
收藏
页数:9
相关论文
共 50 条
  • [31] Unintended harm: A qualitative study of "harm" upon people who inject drugs in Bangkok, Thailand
    Haritavorn, Niphattra
    HEALTH, 2023, 27 (04): : 525 - 539
  • [32] A Multilevel Ecological Model of HIV Risk for People Who Are Homeless or Unstably Housed and Who Use Drugs in the Urban United States
    Bowen, Elizabeth A.
    SOCIAL WORK IN PUBLIC HEALTH, 2016, 31 (04) : 264 - 275
  • [33] Acceptability of, and barriers and facilitators to, a pilot physical health service for people who inject drugs: A qualitative study with service users and providers
    Anderson, Niall C.
    Kesten, Joanna M.
    Ayres, Rachel
    Hickman, Matthew
    Amlot, Richard
    Michie, Susan
    Lorencatto, Fabiana
    INTERNATIONAL JOURNAL OF DRUG POLICY, 2022, 99
  • [34] Qualitative investigation of barriers to accessing care by people who inject drugs in Saskatoon, Canada: perspectives of service providers
    Lang, Katherine
    Neil, Jaycie
    Wright, Judith
    Dell, Colleen Anne
    Berenbaum, Shawna
    El-Aneed, Anas
    SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY, 2013, 8
  • [35] Perspectives on HIV pre-exposure prophylaxis (PrEP) utilization and related intervention needs among people who inject drugs
    Biello, K. B.
    Bazzi, A. R.
    Mimiaga, M. J.
    Biancarelli, D. L.
    Edeza, A.
    Salhaney, P.
    Childs, E.
    Drainoni, M. L.
    HARM REDUCTION JOURNAL, 2018, 15
  • [36] Modeling the impact of the COVID-19 pandemic on achieving HCV elimination amongst young and unstably housed people who inject drugs in San Francisco
    Fraser, Hannah
    Stone, Jack
    Facente, Shelley N.
    Artenie, Adelina
    Patel, Sheena
    Wilson, Erin C.
    McFarland, Willi
    Page, Kimberly
    Vickerman, Peter
    Morris, Meghan D.
    INTERNATIONAL JOURNAL OF DRUG POLICY, 2024, 131
  • [37] Prevalence and correlates of receptive syringe-sharing among people who inject drugs in rural Appalachia
    White, Rebecca Hamilton
    O'Rourke, Allison
    Kilkenny, Michael E.
    Schneider, Kristin E.
    Weir, Brian W.
    Grieb, Suzanne M.
    Sherman, Susan G.
    Allen, Sean T.
    ADDICTION, 2021, 116 (02) : 328 - 336
  • [38] Prevalence and associates of non-fatal overdose among people who inject drugs in Saveh, Iran
    Armoon, Bahram
    Griffiths, Mark D.
    Bayani, Azadeh
    Mohammadi, Rasool
    Ahounbar, Elaheh
    ADDICTION SCIENCE & CLINICAL PRACTICE, 2022, 17 (01)
  • [39] Depression, antiretroviral therapy initiation, and HIV viral suppression among people who inject drugs in Vietnam
    Levintow, Sara N.
    Pence, Brian W.
    Powers, Kimberly A.
    Breskin, Alexander
    Sripaipan, Teerada
    Tran Viet Ha
    Viet Anh Chu
    Vu Minh Quan
    Latkin, Carl A.
    Go, Vivian F.
    JOURNAL OF AFFECTIVE DISORDERS, 2021, 281 : 208 - 215
  • [40] Understanding Contraceptive Needs of Women Who Inject Drugs in Orange County: A Qualitative Study
    Florsheim, Orli K.
    Augustine, Dallas
    Van Ligten, Megan M.
    de Bocanegra, Heike Thiel
    Perry, Rachel
    JOURNAL OF ADDICTION MEDICINE, 2021, 15 (06) : 498 - 503