Centre for Health Evaluation & Outcome Sciences, Providence Health Care, St, Paul's Hospital 620B-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Harm Reduct J. 2012 Jan 25;9:8. doi: 10.1186/1477-7517-9-8.
Substitution with opioid-agonists (e.g., methadone) has shown to be an effective treatment for chronic long-term opioid dependency. Survival sex work, very common among injection drug users, has been associated with poor Opioid Agonist Treatment (OAT) engagement, retention and response. Therefore, this study was undertaken to determine factors associated with engaging in sex work among long-term opioid dependent women receiving OAT.
Data from a randomized controlled trial, the North American Opiate Medication Initiative (NAOMI), conducted in Vancouver and Montreal (Canada) between 2005-2008, was analyzed. The NAOMI study compared the effectiveness of oral methadone to injectable diacetylmorphine or injectable hydromorphone, the last two on a double blind basis, over 12 months. A research team, independent of the clinic services, obtained outcome evaluations at baseline and follow-up (3, 6, 9, 12, 18 and 24 months).
A total 53.6% of women reported engaging in sex work in at least one of the research visits. At treatment initiation, women who were younger and had fewer years of education were more likely to be engaged in sex work. The multivariate logistic generalized estimating equation regression analysis determined that psychological symptoms, and high illicit heroin and cocaine use correlated with women's involvement in sex work during the study period.
After entering OAT, women using injection drugs and engaging in sex work represent a particularly vulnerable group showing poorer psychological health and a higher use of heroin and cocaine compared to women not engaging in sex work. These factors must be taken into consideration in the planning and provision of OAT in order to improve treatment outcomes.
NCT00175357.
阿片类激动剂（如美沙酮）替代治疗已被证明是治疗慢性长期阿片类药物依赖的有效方法。在注射吸毒者中，性交易非常普遍，与较差的阿片类药物替代治疗（OAT）参与度、保留率和反应率相关。因此，本研究旨在确定接受 OAT 的长期阿片类药物依赖女性从事性交易的相关因素。
对 2005-2008 年在温哥华和蒙特利尔（加拿大）进行的北美阿片类药物治疗倡议（NAOMI）随机对照试验的数据进行了分析。该研究比较了口服美沙酮与注射二乙酰吗啡或注射氢吗啡酮的疗效，后两者采用双盲法，为期 12 个月。一个独立于诊所服务的研究团队在基线和随访（3、6、9、12、18 和 24 个月）时获得了结果评估。
共有 53.6%的女性报告在至少一次研究访问中从事过性交易。在治疗开始时，年龄较小和受教育年限较少的女性更有可能从事性交易。多变量逻辑广义估计方程回归分析确定，心理症状以及非法海洛因和可卡因的高使用率与女性在研究期间从事性交易相关。
进入 OAT 后，使用注射毒品并从事性交易的女性代表了一个特别脆弱的群体，与不从事性交易的女性相比，她们的心理健康状况较差，海洛因和可卡因的使用率更高。在规划和提供 OAT 时，必须考虑这些因素，以改善治疗结果。
NCT00175357。
