Lasiychuk Vitaliy, Ghiroli Megan, López-Castro Teresa, Fox Aaron D
Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA.
Harm Reduct J. 2025 Aug 29;22(1):147. doi: 10.1186/s12954-025-01300-1.
In the United States, only 15-20% of people with opioid use disorder (OUD) receive medications for OUD annually. Injectable opioid agonist treatment with hydromorphone (iOAT-H) is a novel approach that reduces non-prescribed opioid use. However, interest in iOAT-H among women, who face unique challenges in OUD treatment, may be different than men. This study evaluates women's attitudes toward iOAT-H, and gender disparities in OUD-related risks, exploring potential gender-specific treatment needs. We hypothesized that women would be less interested in iOAT-H than men given the disproportionate stigma women face in accessing OUD treatment.
This is a secondary analysis of a cross-sectional study of urban syringe service program participants. Participants self-reported interest in iOAT-H, which was assessed on a 4-point scale with 3 or 4 considered "interested." Participants also provided self-reported data on preferences for OUD treatment and their OUD-related risks, including frequency of drug use and injection practices. Descriptive statistics and comparative analyses were employed to explore gender differences.
Of 108 participants, 31% were women and 69% were men with a mean age of 43.0 (SD ± 10.8). Almost all participants had severe OUD (98.1%) and had prior OUD care (96.3%). Most women (68%) and men (64%) reported interest in iOAT-H. For OUD treatment preferences, most women chose iOAT-H (56%), while men most commonly endorsed methadone treatment (42%) as their preferred option. Women had more OUD-related risks than men including injecting more times per day (5 vs. 3, p > 0.01) and injecting in public more often (24 vs. 7, p = 0.05) in the past 30 days.
Interest in iOAT-H was high among women and men, but we found gender differences in OUD-related risks. This may reflect unmet needs among women who would potentially enter treatment with iOAT-H, but additional work is necessary to examine specific risks such as mental health, trauma exposure, and creating safe treatment spaces for women. Nonetheless, iOAT-H appeared acceptable to women in our sample, and many treatment-experienced people who inject drugs would prefer iOAT-H to other available OUD treatments.
在美国，每年仅有15%至20%的阿片类药物使用障碍（OUD）患者接受OUD药物治疗。注射用氢吗啡酮阿片类激动剂治疗（iOAT-H）是一种可减少非处方阿片类药物使用的新方法。然而，在OUD治疗中面临独特挑战的女性对iOAT-H的兴趣可能与男性不同。本研究评估了女性对iOAT-H的态度以及OUD相关风险中的性别差异，探索潜在的性别特异性治疗需求。我们假设，鉴于女性在获得OUD治疗时面临不成比例的污名，她们对iOAT-H的兴趣会低于男性。
这是一项对城市注射器服务项目参与者横断面研究的二次分析。参与者自行报告对iOAT-H的兴趣，该兴趣通过4分制进行评估，3分或4分被视为“感兴趣”。参与者还提供了关于OUD治疗偏好及其OUD相关风险的自我报告数据，包括药物使用频率和注射方式。采用描述性统计和比较分析来探索性别差异。
在108名参与者中，31%为女性，69%为男性，平均年龄为43.0岁（标准差±10.8）。几乎所有参与者都患有严重的OUD（98.1%）且曾接受过OUD护理（96.3%）。大多数女性（68%）和男性（64%）表示对iOAT-H感兴趣。对于OUD治疗偏好，大多数女性选择iOAT-H（56%），而男性最常认可美沙酮治疗（42%）为其首选方案。女性比男性有更多与OUD相关的风险，包括在过去30天内每天注射次数更多（5次对3次，p>0.01）以及更频繁地在公共场合注射（24次对7次，p=0.05）。
女性和男性对iOAT-H的兴趣都很高，但我们发现了与OUD相关风险中的性别差异。这可能反映了可能接受iOAT-H治疗的女性未被满足的需求，但有必要开展更多工作来研究诸如心理健康、创伤暴露以及为女性创造安全治疗空间等特定风险。尽管如此，在我们的样本中iOAT-H似乎为女性所接受，并且许多有注射吸毒治疗经验的人更喜欢iOAT-H而非其他可用的OUD治疗方法。
