Supervised injection facility use and exposure to violence among a cohort of people who inject drugs: A gender-based analysis
Supervised injection facility use and exposure to violence among a cohort of people who inject drugs: A gender-based analysis
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DOI：
10.1016/j.drugpo.2020.102692
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发表时间：
2020-04-01
影响因子：
4.4
通讯作者：
Kerr, Thomas
中科院分区：
文献类型：
--
作者：
Kennedy, Mary Clare;Hayashi, Kanna;Kerr, Thomas
背景资料：在许多环境中建立了受监督的注射设施，部分是为了减少与公共注射有关的风险，包括遭受暴力的风险。然而，使用SIF和经历暴力之间的关系尚未得到彻底评估。我们试图纵向研究SIF使用和暴露于暴力之间的性别特异性关系的人谁注射毒品（PWID）在加拿大setting.Methods：数据来自两个前瞻性队列研究的PWID在温哥华，加拿大，2005年12月和2016年12月之间。参与者每半年填写一次问卷，收集有关社会人口特征、行为模式、暴力遭遇和保健服务利用情况的数据。我们使用多变量广义估计方程（GEE）估计之间的独立关联，专门注射药物在SIF和经历身体或性暴力之间的男性和女性PWID.Results1930 PWID其次为中位数为4年，679（35.2%）是女性和中位年龄为41岁的基线。总共有353名妇女（52.0%）和694名男子（55.5%）报告在随访期间至少经历过一次暴力事件。在多变量分析中，在调整潜在混杂因素后，单独使用SIF与男性经历暴力的几率降低相关（调整后的比值比[AOR] = 0.64; 95%置信区间[CI]：0.46-0.89）。在调整后的分析（AOR = 0.97; 95%CI：0.57-1.66）中，独家SIF使用与女性遭受暴力没有显着相关性。结论：鉴于最近在加拿大扩大了SIF，我们发现独家SIF使用与男性遭受暴力之间存在保护性关联，这是令人鼓舞的。事实上，我们没有观察到SIF的使用和经历暴力之间的显着关联的妇女突出了社会结构的干预措施，更积极地响应妇女PWID在预防暴力方面的具体需求的必要性。
Background: Supervised injection facilities (SIFs) have been established in many settings, in part to reduce risks associated with injecting in public, including exposure to violence. However, the relationship between SIF use and experiencing violence has not yet been thoroughly evaluated. We sought to longitudinally examine the gender-specific relationship between SIF use and exposure to violence among people who inject drugs (PWID) in a Canadian setting.Methods: Data were drawn from two prospective cohort studies of PWID in Vancouver, Canada, between December 2005 and December 2016. Semi-annually, participants completed questionnaires that elicited data concerning sociodemographic characteristics, behavioural patterns, violent encounters and health service utilization. We used multivariable generalized estimating equations (GEE) to estimate the independent association between exclusively injecting drugs at a SIF and experiencing physical or sexual violence among men and women PWID, respectively.Results: Of 1930 PWID followed for a median of four years, 679 (35.2%) were women and the median age was 41 years at baseline. In total, 353 (52.0%) women and 694 (55.5%) men reported experiencing at least one incident of violence during follow-up. In multivariable analyses, exclusive SIF use was associated with decreased odds of experiencing violence among men after adjusting for potential confounders (Adjusted Odds Ratio [AOR] = 0.64; 95% confidence interval [CI]: 0.46-0.89). Exclusive SIF use was not significantly associated with experiencing violence among women in adjusted analyses (AOR = 0.97; 95% CI: 0.57-1.66).Conclusion: In light of the recent expansion of SIFs in Canada, our finding of a protective association between exclusive SIF use and exposure to violence among men is encouraging. The fact that we did not observe a significant association between SIF use and experiencing violence among women highlights the need for social-structural interventions that are more responsive to the specific needs of women PWID in relation to violence prevention.