Sex work involvement among women with long-term opioid injection drug dependence who enter opioid agonist treatment 英文参考文献.docVIP

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Sex work involvement among women with long-term opioid injection drug dependence who enter opioid agonist treatment 英文参考文献.doc

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Sex work involvement among women with long-term opioid injection drug dependence who enter opioid agonist treatment 英文参考文献

Marchandetal.HarmReductionJournal2012,9:8 /content/9/1/8 RESEARCH OpenAccess Sexworkinvolvementamongwomenwithlong- termopioidinjectiondrugdependencewho enteropioidagonisttreatment KirstenMarchand1,EugeniaOviedo-Joekes1,2*,DaphneGuh1,DavidCMarsh3,4,SuzanneBrissette5and MartinTSchechter1,2 Abstract Background:Substitutionwithopioid-agonists(e.g.,methadone)hasshowntobeaneffectivetreatmentfor chroniclong-termopioiddependency.Survivalsexwork,verycommonamonginjectiondrugusers,hasbeen associatedwithpoorOpioidAgonistTreatment(OAT)engagement,retentionandresponse.Therefore,thisstudy wasundertakentodeterminefactorsassociatedwithengaginginsexworkamonglong-termopioiddependent womenreceivingOAT. Methods:Datafromarandomizedcontrolledtrial,theNorthAmericanOpiateMedicationInitiative(NAOMI), conductedinVancouverandMontreal(Canada)between2005-2008,wasanalyzed.TheNAOMIstudycompared theeffectivenessoforalmethadonetoinjectablediacetylmorphineorinjectablehydromorphone,thelasttwoona doubleblindbasis,over12months.Aresearchteam,independentoftheclinicservices,obtainedoutcome evaluationsatbaselineandfollow-up(3,6,9,12,18and24months). Results:Atotal53.6%ofwomenreportedengaginginsexworkinatleastoneoftheresearchvisits.Attreatment initiation,womenwhowereyoungerandhadfeweryearsofeducationweremorelikelytobeengagedinsex work.Themultivariatelogisticgeneralizedestimatingequationregressionanalysisdeterminedthatpsychological symptoms,andhighillicitheroinandcocaineusecorrelatedwithwomen’sinvolvementinsexworkduringthe studyperiod. Conclusions:AfterenteringOAT,womenusinginjectiondrugsandengaginginsexworkrepresentaparticularly vulnerablegroupshowingpoorerpsychologicalhealthandahigheruseofheroinandcocainecomparedto womennotengaginginsexwork.Thesefactorsmustbetakenintoconsiderationintheplanningandprovisionof OATinordertoimprovetreatmentoutcomes. TrialRegistration:NC Keywords:Sexwork,opioiddependence,substitutiontreatment 1.Background unemployment,lossoffamilybonds,andillegalactivity Opioid dependen