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Tam CC, Zhou Y, Benotsch EG, Li X, Qiao S, Zhao Q. Nonmedical use of prescription drugs and biopsychosocial correlates among females who are sex workers in China. Subst Abus 2021; 43:187-193. [PMID: 33872115 DOI: 10.1080/08897077.2021.1903655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Nonmedical use of prescription drugs (NMPUD) has become a critical public health concern. Chinese literature has paid growing attention to NMUPD, but scarce research has focused on females who are sex workers (FSWs), who have a high risk of substance use. The current study aimed to examine NMUPD and its biopsychosocial correlates in Chinese FSWs. Methods: A total of 410 FSWs (mean age = 33.58 years) from Guangxi, China, completed an anonymous, self-administered survey evaluating NMUPD, somatic symptoms, and psychosocial distress. Results: Overall, 46.6% of FSWs reported lifetime NMUPD and 17.6% reported past-3-month NMUPD. The most commonly reported medications that were used nonmedically were analgesics (46.3%, lifetime; 17.6%, past 3 months). A majority of FSWs (69.1%) reported "relieving pain" as the motive of their NMUPD. FSWs reporting NMUPD were more likely to be younger, be unmarried, have higher income, and work in multiple venues/high-paying venues. Somatic symptoms and psychosocial distress were associated with NMUPD in Chinese FSWs. Conclusions: NMUPD was prevalent in Chinese FSWs and was associated with biopsychosocial factors. Critical attention should be paid to NMUPD in FSWs. Future NMUPD prevention intervention among FSWs may benefit from attending to biopsychosocial factors.
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Affiliation(s)
- Cheuk Chi Tam
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Yuejiao Zhou
- Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Eric G Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Qun Zhao
- Research Institute for Environment and Health, Nanjing University of Information Science and Technology, Nanjing, China
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Hurley EA, Duello A, Finocchario-Kessler S, Goggin K, Stancil S, Winnograd RP, Miller MK. Expanding Contraception Access for Women With Opioid-Use Disorder: A Qualitative Study of Opportunities and Challenges. Am J Health Promot 2020; 34:909-918. [PMID: 32468826 PMCID: PMC7577934 DOI: 10.1177/0890117120927327] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE As almost nine in ten pregnancies among women with opioid use disorder (OUD) are unintended, expanding access to contraception is an underutilized but potentially effective strategy in increasing reproductive agency and reducing the overall burden of neonatal abstinence syndrome. We aimed to identify where and how contraceptive services could be integrated into existing points-of-contact for women with OUD. APPROACH In-depth qualitative interviews. SETTING Three diverse catchment areas in Missouri. PARTICIPANTS Women with OUD (n = 15) and professional stakeholders (n = 16) representing five types of existing OUD service points: syringe exchange programs, recovery support programs, substance use treatment programs, emergency departments, and Federally Qualified Health Centers. METHOD Interviews were audio-recorded, transcribed, and thematically coded using Dedoose software. RESULTS Six themes emerged as essential components for integrating contraceptive services into existing points-of-contact for women with OUD: (1) reach women with unmet need; (2) provide free or affordable contraception; (3) maximize service accessibility; (4) provide patient-centered care; (5) employ willing, qualified contraceptive providers; and (6) utilize peer educators. Participants affirmed the overall potential benefit of contraceptive service integration and illuminated various opportunities and challenges relevant to each type of existing service point. CONCLUSION As health promotion initiatives look to increase access to contraception among women with OUD, these six' participant-identified components offer essential guidance in selecting advantageous points-of-contact and addressing remaining gaps in services.
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Affiliation(s)
- Emily A. Hurley
- Division of Health Services and Outcomes Research, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA
- Department of Pediatric, School of Medicine, University of Missouri–Kansas City, Kansas City, MO, USA
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Alex Duello
- Missouri Institute of Mental Health, University of Missouri–St. Louis, St. Louis, MO, USA
| | | | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children’s Mercy Hospitals and Clinics, Kansas City, MO, USA
- Department of Pediatric, School of Medicine, University of Missouri–Kansas City, Kansas City, MO, USA
- School of Pharmacy, University of Missouri–Kansas City, Kansas City, MO, USA
| | - Stephani Stancil
- Dvisions of Adolescent Medicine and Clinical Pharmacology, Children’s Mercy Kansas City, Kansas City, MO, USA
| | - Rachel P. Winnograd
- Missouri Institute of Mental Health, University of Missouri–St. Louis, St. Louis, MO, USA
| | - Melissa K. Miller
- Department of Pediatric, School of Medicine, University of Missouri–Kansas City, Kansas City, MO, USA
- Emergency Medicine, Children’s Mercy Kansas City, Kansas City, MO, USA
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Cheng T, Nosova E, Small W, Hogg RS, Hayashi K, DeBeck K. A gender-based analysis of nonmedical prescription opioid use among people who use illicit drugs. Addict Behav 2019; 97:42-48. [PMID: 31146150 DOI: 10.1016/j.addbeh.2019.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 03/09/2019] [Accepted: 05/20/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Research investigating the unique impacts associated with engaging in nonmedical prescription opioid use (NMPOU) among males and females who also use illicit drugs is needed. METHODS Data were collected between 2013 and 2017 from two linked prospective cohort studies in Vancouver: the At-Risk Youth Study and Vancouver Injection Drug Users Study. Generalized estimating equations were used to identify factors associated with engaging in NMPOU among females and males separately. RESULTS Among 1459 participants, 534 were female (37%). Similar proportions of females (46%) and males (48%) engaged in NMPOU at their first visit during the study period. In multivariable analyses, factors associated with NMPOU among both males and females included heroin use, overdose, drug dealing, and difficulty accessing health and social services. Among females, those who engaged in NMPOU were more likely to report Caucasian or white ethnicity, cocaine use, crystal methamphetamine use, and sex work; among males, those who engaged in NMPOU were older, reported crack use and engaged in binge drug use (all p < 0.05). CONCLUSION The prevalence of NMPOU was similar among males and females who use illicit drugs in Vancouver, and NMPOU was independently associated with markers of vulnerability among both genders. Findings highlight the need for a comprehensive public health approach to address NMPOU that integrates overdose prevention and reversal services, employment opportunities, and better access to services for both women and men.
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Wurcel AG, Burke D, Skeer M, Landy D, Heimer R, Wong JB, Chui KKH, Stopka TJ. Sex work, injection drug use, and abscesses: Associations in women, but not men. Drug Alcohol Depend 2018; 185:293-297. [PMID: 29482054 PMCID: PMC5991097 DOI: 10.1016/j.drugalcdep.2017.12.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Abscesses commonly occur among people who inject drugs (PWID). However, whether the risks are comparable between males and females, and the impact of sex work on abscess risk is unclear. The goal of this study was to examine the contemporary associations of gender and sex work with the risk of abscesses in PWID. METHODS Combining data from two cross-sectional studies conducted in the Greater Boston Area with people at risk for HIV and hepatitis C virus (HCV), we used the following inclusion criteria: age 18-45 years and report of illicit or non-prescription drug injection within the 30 days prior to the survey. Information on demographics, injection-mediated risks, and sexual behaviors was collected using Audio Computer-Assisted Self-Interview Software. Multivariable logistic regressions were used to model associations. RESULTS The study sample included 298 people including 30% were female. Females were more likely than men to report sex work (28% vs. 16%, p = .012) and abscess during their lifetime (55% vs. 37% p = .004). Among the females, engaging in sex work increased by >5-fold the odds of reporting abscesses [Adjusted odds ratio 5.42; 95% CI: 1.27, 23.10]. There was no association between sex work and abscesses among men. DISCUSSION We found a female-specific association between sex work, injection drug use, and abscesses among PWID. Although the cross-sectional designs precluded causal inferences, longitudinal studies could enhance understanding of gender-associated risks for abscesses and inform the development of harm reduction interventions.
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Affiliation(s)
- Alysse G. Wurcel
- Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, United States,Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Deirdre Burke
- Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, United States
| | - Margie Skeer
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - David Landy
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Robert Heimer
- Department of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, CT, United States
| | - John B. Wong
- Division of Clinical Decision Making, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States
| | - Kenneth K. H. Chui
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Thomas J. Stopka
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
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