Nolen Shayla, Wilson Taneisha, Jacka Brendan P, Li Yu, Beaudoin Francesca L, Marshall Brandon D L
Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Box G-S-121-2, Providence, RI 02912, USA.
Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
Addict Behav Rep. 2023 May 18;17:100496. doi: 10.1016/j.abrep.2023.100496. eCollection 2023 Jun.
Our objective is to determine if specific sociodemographic characteristics were associated with perceived drug-related discrimination among people who use drugs (PWUD) presenting for care in the emergency department (ED).
We conducted a secondary analysis of data from the Navigator trial, a randomized control trial of two behavioral interventions in the ED for people at risk of an opioid overdose. Participants included adult patients presenting to two Rhode Island EDs. Eligible participants included those high risk for an opioid overdose, resided or received most of their healthcare in Rhode Island, and were able to provide consent. The primary outcome of this analysis was self-reported feelings of drug-related discrimination by the medical community. The independent variables of interest included race/ethnicity, gender identity, and sexual orientation. Log-binomial multivariable regression models were constructed with all three independent variables of interest and a selection of sociodemographic covariates.
Of 620 eligible participants, 251 (40.5%) reported ever experiencing drug-related discrimination in their lifetime. In the adjusted model, participants who identified as women and participants who identified as LGBQIA+ were more likely to report experiencing drug-related discrimination from the medical community in EDs. Racial/ethnic minority groups were less likely than White (non-Hispanic) participants to report drug-related discrimination.
In this study population, White participants reported more drug-related discrimination than their minority counterparts, although female and LGBQIA+ patients reported more discrimination. Future studies should further assess the significance of these intersecting identities on self-reported discrimination. This knowledge could improve ED-based interventions, policies, and services for PWUD.
我们的目的是确定在急诊科（ED）就诊的吸毒者（PWUD）中，特定的社会人口学特征是否与感知到的与药物相关的歧视有关。
我们对Navigator试验的数据进行了二次分析，该试验是一项针对有阿片类药物过量风险人群在急诊科进行的两种行为干预的随机对照试验。参与者包括前往罗德岛两家急诊科就诊的成年患者。符合条件的参与者包括有阿片类药物过量高风险、居住在罗德岛或在罗德岛接受大部分医疗服务且能够提供同意的人。该分析的主要结果是自我报告的来自医学界的与药物相关的歧视感受。感兴趣的自变量包括种族/民族、性别认同和性取向。构建了包含所有三个感兴趣的自变量和一系列社会人口学协变量的对数二项式多变量回归模型。
在620名符合条件的参与者中，251人（40.5%）报告一生中曾经历过与药物相关的歧视。在调整后的模型中，自我认同为女性的参与者和自我认同为LGBQIA+的参与者更有可能报告在急诊科受到来自医学界的与药物相关的歧视。少数种族/民族群体比白人（非西班牙裔）参与者报告与药物相关歧视的可能性更小。
在这个研究人群中，白人参与者报告的与药物相关的歧视比少数族裔参与者更多，尽管女性和LGBQIA+患者报告的歧视更多。未来的研究应进一步评估这些交叉身份对自我报告歧视的重要性。这些知识可以改善针对吸毒者的基于急诊科的干预措施、政策和服务。
