Goeieman Daniela S, Mash Robert, Gloeck Natasha R, Scheibe Andrew
Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Division of Family Medicine and Primary Care, Stellenbosch University, Stellenbosch, South Africa
Division of Clinical Associates, Department of Family Medicine and Primary Care (DFMPC), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BJGP Open. 2025 Apr 24;9(1). doi: 10.3399/BJGPO.2024.0049. Print 2025 Apr.
Women who use drugs face specific challenges compared with men such as higher rates of HIV infection, unsafe injecting practices, and intimate partner violence (IPV). However, this population's access to drug dependence treatment and gender-sensitive interventions remains limited, leading to unmet needs and increased vulnerability.
To investigate the characteristics of and associations with retention in care among women on opioid substitution therapy (OST) in a community-based primary care setting.
DESIGN & SETTING: A descriptive observational study within the Community Orientated Substance Use Programme in Tshwane, South Africa.
Data from 199 women (aged 18 years) on OST was extracted from an electronic database and paper-based files. Data were analysed descriptively, and inferential analysis looked for association of variables with retention on OST for ≥6 months.
The majority of participants were unemployed, with 44.3% aged 20-29 years. During the initiation and course of OST, 39.2% of women had an intimate partner of which 37.2% reported IPV, and 19.2% were pregnant. Retention on OST was significantly associated with increasing age at initiation ( = 0.047), knowledge of HIV status ( = 0.029), an increase in the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) score ( = 0.023), and methadone dose (<0.001). Factors such as race, employment status, health-system level, pregnancy, intimate partner using substances, IPV, route of administering opioids, and having tuberculosis and/or hepatitis C exposure did not show a significant relationship with retention on OST (>0.05).
This study reveals specific vulnerabilities in women receiving OST, emphasising the need for the integration of interventions to address reproductive health, violence mitigation, infectious disease, and polydrug use into care.
与男性相比，吸毒女性面临着一些特殊挑战，如艾滋病毒感染率较高、不安全的注射行为以及亲密伴侣暴力（IPV）。然而，这一人群获得药物依赖治疗和性别敏感干预措施的机会仍然有限，导致需求未得到满足且脆弱性增加。
调查社区基层医疗环境中接受阿片类药物替代疗法（OST）的女性在治疗依从性方面的特征及相关因素。
在南非茨瓦内的社区导向物质使用项目中进行的一项描述性观察研究。
从电子数据库和纸质档案中提取了199名接受OST治疗的18岁及以上女性的数据。对数据进行描述性分析，并进行推断性分析以寻找与OST治疗≥6个月的依从性相关的变量。
大多数参与者失业，44.3%的人年龄在20 - 29岁之间。在OST治疗开始和过程中，39.2%的女性有亲密伴侣，其中37.2%报告遭受过IPV，19.2%的女性怀孕。OST治疗的依从性与开始治疗时年龄的增加（= 0.047）、对艾滋病毒感染状况的了解（= 0.029）、酒精、吸烟和物质使用参与度筛查测试（ASSIST）得分的增加（= 0.023）以及美沙酮剂量（<0.001）显著相关。种族、就业状况、卫生系统级别、怀孕、亲密伴侣使用药物、IPV、阿片类药物给药途径以及曾接触过结核病和/或丙型肝炎等因素与OST治疗的依从性没有显著关系（>0.05）。
本研究揭示了接受OST治疗的女性存在的特定脆弱性，强调需要将解决生殖健康、减少暴力、传染病和多药使用的干预措施纳入护理之中。
