Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
, Oakland, USA.
Harm Reduct J. 2023 Jun 9;20(1):71. doi: 10.1186/s12954-023-00793-y.
The COVID-19 pandemic disrupted healthcare and substance use services engagement, including primary and mental health services as well as residential and outpatient drug treatment. Women who inject drugs (WWID) face known barriers to healthcare and substance use service engagement, which pre-date the COVID-19 pandemic. The impact of COVID-19 on WWID's engagement with healthcare and substance use services, however, remains understudied.
To explore the impact of the COVID-19 pandemic on service-seeking and utilization, we conducted in-depth interviews with 27 cisgender WWID in Baltimore, Maryland, in April-September 2021. Iterative, team-based thematic analysis of interview transcripts identified disruptions and adaptations to healthcare and substance use services during the COVID-19 pandemic.
The COVID-19 pandemic disrupted service engagement for WWID through service closures, pandemic safety measures restricting in-person service provision, and concerns related to contracting COVID-19 at service sites. However, participants also described various service adaptations, including telehealth, multi-month prescriptions, and expanded service delivery modalities (e.g., mobile and home delivery of harm reduction services), which overwhelmingly increased service engagement.
To build upon service adaptations occurring during the pandemic and maximize expanded access for WWID, it is vital for healthcare and substance use service providers to continue prioritizing expansion of service delivery modality options, like telehealth and the provision of existing harm reduction services through alternative platforms (e.g., mobile services), that facilitate care continuity and increase coverage.
COVID-19 大流行扰乱了医疗保健和药物使用服务的参与，包括初级和精神卫生服务以及住院和门诊药物治疗。注射毒品的妇女（WWID）面临着已知的医疗保健和药物使用服务参与障碍，这些障碍可以追溯到 COVID-19 大流行之前。然而，COVID-19 对 WWID 与医疗保健和药物使用服务的参与情况的影响仍在研究之中。
为了探索 COVID-19 大流行对寻求和利用服务的影响，我们于 2021 年 4 月至 9 月在马里兰州巴尔的摩市对 27 名顺性别 WWID 进行了深入访谈。对访谈记录进行迭代、团队为基础的主题分析，确定了 COVID-19 大流行期间医疗保健和药物使用服务的中断和适应。
COVID-19 大流行通过服务关闭、限制面对面服务提供的大流行安全措施以及在服务场所感染 COVID-19 的担忧，扰乱了 WWID 的服务参与。然而，参与者还描述了各种服务适应措施，包括远程医疗、多月份处方和扩大服务提供模式（例如，减少伤害服务的移动和家庭提供），这些措施极大地增加了服务参与度。
为了在大流行期间建立服务适应措施并为 WWID 扩大获得服务的机会，医疗保健和药物使用服务提供者必须继续优先扩大服务提供模式选择，如远程医疗和通过替代平台（例如，移动服务）提供现有减少伤害服务，以促进护理连续性并增加覆盖面。
