Determinants of willingness to enroll in opioid agonist treatment among opioid dependent people who inject drugs in Ukraine.
Determinants of willingness to enroll in opioid agonist treatment among opioid dependent people who inject drugs in Ukraine.
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DOI：
10.1016/j.drugalcdep.2016.06.011
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发表时间：
2016-08-01
影响因子：
4.2
通讯作者：
Altice, Frederick L.
中科院分区：
文献类型：
--
作者：
Makarenko, Iuliia;Mazhnaya, Alyona;Polonsky, Maxim;Marcus, Ruthanne;Bojko, Martha J.;Filippoyych, Sergii;Springer, Sandra;Dvoriak, Sergii;Altice, Frederick L.
对于乌克兰的310，000名注射毒品者（PWID），阿片类激动剂治疗（OAT）的覆盖率较低（N= 8，400，2.7%）。在该地区对OAT普遍持负面态度的背景下，迫切需要针对患者的障碍和启动OAT的意愿进行干预。使用多变量logistic回归对来自乌克兰五个地区的1，179名目前未使用OAT的阿片类药物依赖性PWID样本进行了评估，以确定与启动OAT意愿相关的独立因素，并根据其过去的OAT经验进行分层。总体而言，421例（36%）PWID愿意启动OAT。两组中与启动OAT意愿相关的协变量的显著调整比值比（aOR）包括：较高的注射频率（以前接受过OAT：aOR=2.7;从未接受过OAT：aOR=1.8），社会和家庭支持（既往服用OAT：aOR=2.0;从未服用OAT：aOR=2.0），对OAT的积极态度（既往服用OAT：aOR=1.3;从未服用OAT：aOR=1.4）。在先前接受OAT的参与者中，显着相关性还包括：HIV阴性状态（aOR=2.6）和抑郁症（aOR=2.7）。然而，在从未使用过OAT的参与者中，居住在基辅（aOR=4.8）或利沃夫（aOR=2.7），以前的监禁（aOR=1.5），在麻醉科服务注册（aOR=1.5）和最近的过量（aOR=2.6）与启动OAT的意愿显着相关。这些研究结果强调，需要制定干预措施，旨在消除乌克兰阿片类药物依赖性PWID中现有的关于OAT的负面偏见，这些干预措施应针对不同地理环境中PWID的具体特征，更高的注射频率，之前的监禁以及精神病和艾滋病毒状况的需求。
Coverage with opioid agonist treatments (OAT) is low (N=8,400, 2.7%) for the 310,000 people who inject drugs (PWID) in Ukraine. In the context of widespread negative attitudes toward OAT in the region, patient-level interventions targeting the barriers and willingness to initiate OAT are urgently needed. A sample of 1,179 opioid dependent PWID not currently on OAT from five regions in Ukraine was assessed using multivariable logistic regression for independent factors related to willingness to initiate OAT, stratified by their past OAT experience. Overall, 421 (36%) PWID were willing to initiate OAT. Significant adjusted odds ratios (aOR) for covariates associated with the willingness to initiate OAT common for both groups included: higher injection frequency (previously on OAT: aOR=2.7; never on OAT: aOR=1.8), social and family support (previously on OAT: aOR=2.0; never on OAT: aOR=2.0), positive attitude towards OAT (previously on OAT: aOR=1.3; never on OAT: aOR=1.4). Among participants previously on OAT, significant correlates also included: HIV-negative status (aOR=2.6) and depression (aOR=2.7). Among participants never on OAT, however, living in Kyiv (aOR=4.8) or Lviv (aOR=2.7), previous imprisonment (aOR=1.5), registration at a Narcology service (aOR=1.5) and recent overdose (aOR=2.6) were significantly correlated with willingness to initiate OAT. These findings emphasize the need for developing interventions aimed to eliminate existing negative preconceptions regarding OAT among opioid dependent PWID in Ukraine, which should be tailored to the needs of specific characteristics of PWID in geographically distinct setting, higher injection frequency, prior incarceration, and psychiatric and HIV status.
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