Prevalence and correlates of nonmedical prescription opioid use among a cohort of sex workers in Vancouver, Canada
Prevalence and correlates of nonmedical prescription opioid use among a cohort of sex workers in Vancouver, Canada
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DOI：
10.1016/j.drugpo.2014.07.010
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发表时间：
2015-01-01
影响因子：
4.4
通讯作者：
Shannon, Kate
中科院分区：
文献类型：
--
作者：
Argento, Elena;Chettiar, Jill;Shannon, Kate
背景资料：处方阿片类药物（PO）的非医疗使用是一个主要的公共卫生问题，在北美造成广泛的发病率和死亡率。加拿大是全球PO消费率第二高的国家，数据显示非医疗PO使用（NPOU）在关键人群中不断增长，并且在街头毒品市场上越来越多。尽管有越来越多的证据证明NPOU的兴起，但很少有研究系统地研究加拿大主要弱势群体（如性工作者）中的NPOU。本研究前瞻性地评估了NPOU的患病率和相关性在一个温哥华队列的性workers. Methods的三年following.Methods：数据来自一个开放的前瞻性队列，AESHA（评估性工作者健康访问）在大都会温哥华，加拿大（2010-2013）。妇女是通过从室外街道和室内场所的外联活动招募的。使用广义估计方程（GEE）的二元和多变量Logistic回归被用来检查社会和结构相关的NPOU超过36 months.Results：在基线的692名性工作者，近五分之一（n= 130，18.8%）报告NPOU（注射或非注射）在过去的六个月。在多变量GEE分析中，与近期NPOU独立相关的因素为：交换性别而高（AOR 3.26，95%CI 2.29-4.64），警察骚扰/逮捕（AOR 1.83，95%CI 1.43-2.35），亲密伴侣注射药物（AOR 1.66，95%CI 1.11-2.49）和最近的身体/性亲密伴侣暴力（AOR 1.65，95%CI 1.21-2.24）。结论：我们的研究结果表明，温哥华近五分之一的性工作者报告NPOU。与NPOU独立统计相关的因素包括交换性行为，而高，警察骚扰/逮捕，注射毒品的亲密伴侣和最近的身体/性亲密伴侣暴力。性工作者中NPOU使用率很高，这凸显了针对这一关键人群制定进一步预防和管理策略的必要性。这里揭示的NPOU的相关性表明，可以进一步实施结构性干预措施，以改善这一日益严重的问题。(C)2014爱思唯尔有限公司版权所有。
Background: The nonmedical use of prescription opioids (POs) is a major public health concern, causing extensive morbidity and mortality in North America. Canada has the second highest consumption rate of POs globally and data indicate nonmedical PO use (NPOU) is growing among key populations and increasingly available in street-level drug markets. Despite accumulating evidence documenting the rise of NPOU, few studies have systematically examined NPOU in Canada among Key vulnerable populations, such as sex workers. This study prospectively evaluated the prevalence and correlates of NPOU within a Vancouver cohort of sex workers over three-years follow-up.Methods: Data were drawn from an open prospective cohort, AESHA (An Evaluation of Sex Workers Health Access) in Metro Vancouver, Canada (2010-2013). Women were recruited through outreach from outdoor street locations and indoor venues. Bivariate and multivariable logistic regression using Generalized Estimating Equations (GEE) were used to examine social and structural correlates of NPOU over 36 months.Results: Of the 692 sex workers at baseline, close to one-fifth (n= 130, 18.8%) reported NPOU (injection or non-injection) in the last six months. In multivariable GEE analyses, factors independently correlated with recent NPOU were: exchanging sex while high (AOR 3.26, 95%CI 2.29-4.64), police harassment/arrest (AOR 1.83, 95%CI 1.43-2.35), intimate partner injects drugs (AOR 1.66, 95%CI 1.11-2.49), and recent physical/sexual intimate partner violence (AOR 1.65, 95%Cl 1.21-2.24).Conclusion: Our results demonstrate that nearly one-fifth of sex workers in Metro Vancouver report NPOU. Factors independently statistically associated with NPOU included exchanging sex while high, police harassment/arrest, a drug injecting intimate partner and recent physical/sexual intimate partner violence. The high prevalence of NPOU use among sex workers underscores the need for further prevention and management strategies tailored to this key population. The correlates of NPOU uncovered here suggest that structural interventions may be further implemented to ameliorate this growing concern. (C) 2014 Elsevier B.V. All rights reserved.