Gender disparities in access and retention in outpatient methadone treatment for opioid use disorder in low-income urban communities.
Gender disparities in access and retention in outpatient methadone treatment for opioid use disorder in low-income urban communities.
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DOI：
10.1016/j.jsat.2021.108399
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发表时间：
2021-08
影响因子：
3.9
通讯作者：
Guerrero E
中科院分区：
文献类型：
--
作者：
Marsh JC;Amaro H;Kong Y;Khachikian T;Guerrero E
本研究的目的是检测和了解性别差异的访问和保留之间的门诊美沙酮治疗计划位于低收入城市社区在洛杉矶，加州。该研究收集了2011年，2013年，2015年和2017年4波的客户和项目数据，来自34个公共资助的美沙酮治疗项目，为11，169名阿片类药物使用障碍（OUD）客户提供服务。样本包括29.8%的女性和70.2%的男性客户，其中10.6%被确定为黑人或非裔美国人，41.5%为拉丁美洲人，44.2%为非拉丁美洲人白色，3.8%为其他。我们进行了两个多层次的负二项回归模型，以检查直接和适度的关系，访问（等待名单上的天数）和保留（治疗天数），同时考虑到客户群内的程序。在获得治疗和保持治疗方面都存在性别差异，妇女等待接受治疗的时间比男子多，但接受治疗的时间更长。此外，与非拉丁裔白色和男性相比，非裔美国人、拉丁裔和其他女性客户接受更短治疗的风险更大。总体而言，在低收入社区接受美沙酮治疗的OUD客户在获得和保留与精神疾病，家庭责任和使用严重程度相关的治疗方面遇到了障碍。具有MediCal保险资格的OUD客户始终更有可能获得并继续接受美沙酮治疗。总体而言，研究结果呼吁通过全面，性别特异性和循证规划，改善接受美沙酮门诊美沙酮治疗计划的OUD妇女的治疗机会和保留。
The purpose of this study was to detect and understand gender disparities in access and retention among outpatient methadone treatment programs located in low-income urban communities in Los Angeles, California. The study collected client- and program-level data in 4 waves in 2011, 2013, 2015, and 2017 from 34 publicly funded methadone treatment programs serving 11,169 clients with opioid use disorder (OUD). The sample included 29.8% female and 70.2% male clients, where 10.6% identified as Black or African American, 41.5% as Latino, 44.2% as non-Latino white, and 3.8% as Other. We conducted two multilevel negative binomial regression models to examine direct and moderated relationships related to both access (days on the waitlist) and retention (days in treatment) while accounting for clients clustered within programs. Gender disparities existed in both access and retention where women spent more time than men waiting to enter treatment but then remained in treatment longer. Further, female clients identifying as African American, Latino, and Other were at greater risk for shorter treatment duration than those who identified as non-Latino white and men. Overall, OUD clients receiving methadone treatment in low-income neighborhoods experienced barriers to access to and retention in treatment associated with mental illness, family responsibilities, and use severity. OUD clients with MediCal insurance eligibility were consistently more likely to gain access to and remain in methadone treatment. Overall, findings call for improving treatment access and retention for women with OUD who receive methadone in outpatient methadone treatment programs through comprehensive, gender-specific, and evidence-based programming.
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DOI：
10.1186/s13011-015-0036-z
发表时间：
2015-10-26
期刊：
Substance abuse treatment, prevention, and policy
影响因子：
--
作者：
Guerrero EG;Fenwick K;Kong Y;Grella C;D'Aunno T
通讯作者：
D'Aunno T
影响因子：
3.9
作者：
Marsh, JC;Cao, DC;D'Aunno, T
通讯作者：
D'Aunno, T
影响因子：
0.9
作者：
Grella, CE;Joshi, V;Hser, YI
通讯作者：
Hser, YI
影响因子：
6.4
作者：
Marcelin, Jasmine R.;Siraj, Dawd S.;Maldonado, Yvonne A.
通讯作者：
Maldonado, Yvonne A.
影响因子：
3.4
作者：
Guerrero, Erick G.;Marsh, Jeanne C.;Lee, Benedict
通讯作者：
Lee, Benedict