A rapid ethnographic study of risk negotiation during the COVID-19 pandemic among unstably housed people who use drugs in Rhode Island.
A rapid ethnographic study of risk negotiation during the COVID-19 pandemic among unstably housed people who use drugs in Rhode Island.
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DOI：
10.1016/j.drugpo.2022.103626
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发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Marshall BDL
中科院分区：
文献类型：
--
作者：
Collins AB;Edwards S;McNeil R;Goldman J;Hallowell BD;Scagos RP;Marshall BDL
COVID-19大流行大大加剧了美国的用药过量危机。然而，2019冠状病毒病和药物过量危机的重叠影响并不相同，住房不稳定的吸毒者（PWUD）受到的影响尤为严重。在这些变化中，有必要了解如何在住房不稳定的贫困妇女中经历和管理风险，以更有效地满足健康和社会需求。该项目借鉴了2020年6月至2021年4月在罗德岛进行的人种学研究。数据包括对居住不稳定的PWUD进行的39次深度访谈，以及与街头外展工作者一起进行的大约50小时的人种学田野调查。COVID-19风险主要与参与者先前的过量事件经历和不良健康结果有关。然而，参与者具有不同程度的风险承受能力，其管理方式使他们能够在重叠的公共卫生危机的不确定性中重新确立控制权和代理权。鉴于参与者的结构性脆弱性，在满足其基本生存需求的同时，对COVID-19风险进行了管理。调查结果表明，与covid相关的公共卫生措施（例如，居家令、关闭服务）如何以增加其健康和社会危害风险的方式强化了参与者的结构性脆弱性。实施和扩大满足个人基本需求的规划，包括永久性住房、社会支持和过量预防干预措施（例如，监督消费场所），对于解决住房不稳定的PWUD面临的交叉风险至关重要。
The COVID-19 pandemic has greatly exacerbated the United States’ overdose crisis. However, the overlapping impacts of COVID-19 and the overdose crisis have not been experienced equally, with unstably housed people who use drugs (PWUD) disproportionately impacted. Amid these changes, there is a need to understand how risk is experienced and managed among unstably housed PWUD to address health and social needs more effectively. This project draws on ethnographic research conducted from June 2020 to April 2021 in Rhode Island. Data include 39 in-depth interviews with unstably housed PWUD and approximately 50 h of ethnographic fieldwork conducted alongside street-based outreach workers. COVID-19 risks were primarily contextualized in relation to participants’ prior experiences of overdose events and adverse health outcomes. However, participants had varying levels of risk tolerance that were managed in ways that allowed them to reassert control and agency within the uncertainty of overlapping public health crises. Given participants’ level of structural vulnerabilities, COVID-19 risk was managed alongside meeting their basic needs to survive. Findings demonstrate how COVID-related public health measures (e.g., stay-at-home orders, service closures) reinforced participants’ structural vulnerabilities in ways that increased their risk of health and social harms. Implementing and scaling up programs that meet the basic needs of individuals, including permanent housing, social supports, and overdose prevention interventions (e.g., supervised consumption sites) is critically needed to address intersecting risks faced by unstably housed PWUD.
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DOI：
10.1097/qai.0b013e3181f9c0b6
发表时间：
2010-12
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Friedland G
通讯作者：
Friedland G
影响因子：
4.4
作者：
Collins, Alexandra B.;Boyd, Jade;McNeil, Ryan
通讯作者：
McNeil, Ryan
影响因子：
12.7
作者：
Friedman, Joseph;Akre, Samir
通讯作者：
Akre, Samir
影响因子：
4.8
作者：
Collins, Alexandra B.;Boyd, Jade;McNeil, Ryan
通讯作者：
McNeil, Ryan
影响因子：
4.4
作者：
Friedman, Samuel R.;Rossi, Diana;Braine, Naomi
通讯作者：
Braine, Naomi