Challenges posed by COVID-19 to people who inject drugs and lessons from other outbreaks
Challenges posed by COVID-19 to people who inject drugs and lessons from other outbreaks
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DOI：
10.1002/jia2.25583
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发表时间：
2020-07-01
影响因子：
6
通讯作者：
Friedman, Samuel R.
中科院分区：
文献类型：
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作者：
Vasylyeva, Tetyana, I;Smyrnov, Pavlo;Friedman, Samuel R.
引言鉴于COVID-19疫情，我们正作出相当大的努力以识别及保护处于风险中的人士。毒品使用的刑事定罪、污名化和心理、身体、行为和经济后果使注射毒品者极易感染许多传染病。虽然药物使用与血液传播和性传播感染之间的关系得到了很好的研究，但对PWID中其他传染病爆发的关注较少。COVID-19可能会对PWID产生负面影响，因为合并症的高患病率使疾病更加严重，不卫生和过度拥挤的生活条件，污名化，常见的监禁，无家可归以及难以遵守隔离，社交距离或自我隔离规定。COVID-19大流行还危及PWID服务的基本要素，例如针具交换或替代治疗计划，这些服务可能会在短期和长期受到影响。重要的是，有大量证据表明PWID中的其他传染病爆发与导致COVID-19传播的因素有关，例如卫生条件差，过度拥挤的生活条件和公共使用药物的方式。结论COVID-19危机可能会增加PWID的无家可归，过量用药和不安全注射和性行为的风险。为了解决现有的不平等问题，在设计针对COVID-19大流行的包容性卫生应对措施时，与PWID倡导团体进行磋商至关重要。
Introduction In light of the COVID-19 pandemic, considerable effort is going into identifying and protecting those at risk. Criminalization, stigmatization and the psychological, physical, behavioural and economic consequences of substance use make people who inject drugs (PWID) extremely vulnerable to many infectious diseases. While relationships between drug use and blood-borne and sexually transmitted infections are well studied, less attention has been paid to other infectious disease outbreaks among PWID. Discussion COVID-19 is likely to disproportionally affect PWID due to a high prevalence of comorbidities that make the disease more severe, unsanitary and overcrowded living conditions, stigmatization, common incarceration, homelessness and difficulties in adhering to quarantine, social distancing or self-isolation mandates. The COVID-19 pandemic also jeopardizes essential for PWID services, such as needle exchange or substitution therapy programmes, which can be affected both in a short- and a long-term perspective. Importantly, there is substantial evidence of other infectious disease outbreaks in PWID that were associated with factors that enable COVID-19 transmission, such as poor hygiene, overcrowded living conditions and communal ways of using drugs. Conclusions The COVID-19 crisis might increase risks of homelessnes, overdoses and unsafe injecting and sexual practices for PWID. In order to address existing inequalities, consultations with PWID advocacy groups are vital when designing inclusive health response to the COVID-19 pandemic.