期刊
DRUG AND ALCOHOL DEPENDENCE
卷 165, 期 -, 页码 213-220出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2016.06.011
关键词
Opioid agonist treatments; Drug injection; Opioid use disorder; HIV; Ukraine
资金
- National Institute on Drug Abuse [R01 DA029910, R01 DA033679]
- Fogarty International Center [D43TW000233]
- National Institute of Allergy and Infectious Diseases [R25 TW009338]
- [K24 DA017072]
Background: Coverage with opioid agonist treatments (OAT) that include methadone and buprenorphine is low (N=8400, 2.7%) for the 310,000 people who inject drugs (PWID) in Ukraine. In the context of widespread negative attitudes toward OAT in the region, patient-level interventions targeting the barriers and willingness to initiate OAT are urgently needed. Methods: A sample of 1179 PWID with opioid use disorder not currently on OAT from five regions in Ukraine was assessed using multivariable logistic regression for independent factors related to willingness to initiate OAT, stratified by their past OAT experience. Results: Overall, 421 (36%) PWID were willing to initiate OAT. Significant adjusted odds ratios (aOR) for covariates associated with the willingness to initiate OAT common for both groups included: higher injection frequency (previously on OAT: aOR = 2.7; never on OAT: aOR = 1.8), social and family support (previously on OAT: aOR = 2.0; never on OAT: aOR = 2.0), and positive attitude towards OAT (previously on OAT: aOR = 1.3; never on OAT: aOR = 1.4). Among participants previously on OAT, significant correlates also included: HIV-negative status (aOR = 2.6) and depression (aOR = 2.7). Among participants never on OAT, however, living in Kyiv (aOR = 4.8) or Lviv (aOR = 2.7), previous imprisonment (aOR = 1.5), registration at a Narcology service (aOR = 1.5) and recent overdose (aOR = 2.6) were significantly correlated with willingness to initiate OAT. Conclusions: These findings emphasize the need for developing interventions aimed to eliminate existing negative preconceptions regarding OAT among PWID with opioid use disorder in Ukraine, which should be tailored to meet the needs of specific characteristics of PWID in geographically distinct setting based upon injection frequency, prior incarceration, and psychiatric and HIV status. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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