British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Interdisciplinary Studies Graduate Program, University of British Columbia, 270-2357 Main Mall, H.R. MacMillan Building, Vancouver, BC, V6T 1Z4, Canada.
BMC Public Health. 2019 Mar 8;19(1):284. doi: 10.1186/s12889-019-6606-7.
While supervised injection services (SIS) feasibility research has been conducted in large urban centres across North America, it is unknown whether these services are acceptable among people who inject drugs (PWID) in remote, mid-size cities. We assessed willingness to use SIS and expected frequency of SIS use among PWID in Thunder Bay, a community in Northwestern, Ontario, Canada, serving people from suburban, rural and remote areas of the region.
Between June and October 2016, peer research associates administered surveys to PWID. Sociodemographic characteristics, drug use and behavioural patterns associated with willingness to use SIS and expected frequency of SIS use were estimated using bivariable and multivariable logistic regression models. Design preferences and amenities identified as important to provide alongside SIS were assessed descriptively.
Among 200 PWID (median age, IQR: 35, 28-43; 43% female), 137 (69%) reported willingness to use SIS. In multivariable analyses, public injecting was positively associated with willingness to use (Adjusted Odds Ratio (AOR): 4.15; 95% confidence interval (CI): 2.08-8.29). Among those willing to use SIS, 87 (64%) said they would always/usually use SIS, while 48 (36%) said they would sometime/occasionally use SIS. In multivariable analyses, being female (AOR: 2.44; 95% CI: 1.06-5.65) and reporting injecting alone was positively associated with higher expected frequency of use (AOR: 2.59; 95% CI: 1.02-6.58).
Our findings suggest that SIS could play a role in addressing the harms of injection drug use in remote and mid-sized settings particularly for those who inject in public, as well as women and those who inject alone, who report higher expected frequency of SIS use. Design preferences of local PWID, in addition to differences according to gender should be taken into consideration to maximize the uptake of SIS, alongside existing health and social service provisions available to PWID.
尽管在北美的大型城市中心已经开展了监督注射服务（SIS）的可行性研究，但在偏远的中型城市中，这些服务是否能被吸毒者（PWID）接受尚不清楚。我们评估了在 Thunder Bay 的吸毒者使用 SIS 的意愿和预期频率，该社区位于加拿大安大略省西北部，为该地区郊区、农村和偏远地区的人们提供服务。
在 2016 年 6 月至 10 月期间，同行研究助理向吸毒者进行了调查。使用双变量和多变量逻辑回归模型，估计了与使用 SIS 的意愿和预期 SIS 使用频率相关的社会人口特征、药物使用和行为模式。使用描述性方法评估了与 SIS 一起提供的设计偏好和便利设施。
在 200 名吸毒者（中位数年龄，IQR：35，28-43；43%为女性）中，有 137 名（69%）表示愿意使用 SIS。在多变量分析中，公开注射与使用 SIS 的意愿呈正相关（调整后的优势比（AOR）：4.15；95%置信区间（CI）：2.08-8.29）。在愿意使用 SIS 的人群中，87 人（64%）表示他们会一直/通常使用 SIS，而 48 人（36%）表示他们会偶尔/有时使用 SIS。在多变量分析中，女性（AOR：2.44；95% CI：1.06-5.65）和报告独自注射与更高的预期使用频率呈正相关（AOR：2.59；95% CI：1.02-6.58）。
我们的研究结果表明，SIS 可以在解决偏远和中型地区注射吸毒带来的危害方面发挥作用，特别是对于那些在公共场所注射的人，以及那些报告预期使用 SIS 频率较高的女性和独自注射的人。应考虑当地吸毒者的设计偏好，以及根据性别差异，以便在现有的卫生和社会服务提供给吸毒者的基础上，最大限度地提高 SIS 的采用率。
