Winiker Abigail K, Patel Eshan U, Genberg Becky L, Ching Jennifer, Schluth Catherine, Mehta Shruti H, Kirk Gregory D, Grieb Suzanne M
Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Hous Policy Debate. 2024 Jul 30. doi: 10.1080/10511482.2024.2378807.
People experiencing homelessness with a substance use disorder are a highly structurally vulnerable population, facing a unique burden of compounding stigma, discrimination, and adverse health outcomes. Evidence remains mixed on best practices for housing interventions designed to best meet the needs of this population. Ten people with a history of injection drug use experiencing homelessness during the COVID-19 pandemic were interviewed between July, 2021 and February, 2022 in Baltimore, Maryland. Thematic analysis was used to characterize the pandemic's impact on resource access, housing, and substance use among these participants. Participants highlighted substantial challenges resulting from structural changes during the pandemic, including limits on income-generating opportunities and resource access, and increases in experiences of stigma and discrimination. However, several individuals reported decreased substance use in response to changes to their housing status, with those placed in secure housing attributing their decreased use to this change. These accounts can help guide housing and social support interventions best suited to meet the unique needs of people experiencing homelessness with substance use disorders.
患有物质使用障碍的无家可归者是一个在结构上极为脆弱的群体，面临着耻辱感、歧视和不良健康后果交织的独特负担。关于旨在最好地满足这一群体需求的住房干预措施的最佳做法，证据仍然参差不齐。2021年7月至2022年2月期间，在马里兰州巴尔的摩对10名在新冠疫情期间有注射吸毒史且无家可归的人进行了访谈。采用主题分析法来描述疫情对这些参与者获取资源、住房和物质使用的影响。参与者强调了疫情期间结构变化带来的重大挑战，包括创收机会和资源获取受限，以及耻辱感和歧视经历的增加。然而，有几个人报告称，由于住房状况的改变，物质使用减少了，那些住进安全住房的人将使用减少归因于这一变化。这些描述有助于指导最适合满足患有物质使用障碍的无家可归者独特需求的住房和社会支持干预措施。
