A peer-led mobile outreach program and increased utilization of detoxification and residential drug treatment among female sex workers who use drugs in a Canadian setting |
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Authors: | Kathleen N. Deering Thomas Kerr Mark W. Tyndall Julio S.G. Montaner Kate GibsonLaurel Irons Kate Shannon |
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Affiliation: | a School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3 b BC Centre for Excellence in HIV/AIDS, St. Paul''s Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6 c Department of Medicine, University of British Columbia, Gordon and Leslie Diamond Health Care Centre, 10th Floor, Room 10203, 2775 Laurel Street, Vancouver, BC, Canada V5Z 1M9 d Women''s Information Safe Haven (WISH) Drop-In Centre Society, 330 Alexander Street, Vancouver, BC, Canada V6A 1C3 e Prostitution Alternatives Counselling & Education Society (PACE), 49 West Cordova Street, Vancouver BC, Canada V6B 1C8 |
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Abstract: | BackgroundThe objectives of this study were to examine the determinants of using a peer-led mobile outreach program (the Mobile Access Project [MAP]) among a sample of street-based female sex workers (FSWs) who use drugs in an urban Canadian setting and evaluate the relationship between program exposure and utilizing addiction treatment services.MethodsA detailed questionnaire was administered at baseline and bi-annual follow-up visits over 18 months (2006-2008) to 242 FSWs in Vancouver, Canada. We used bivariate and multivariate logistic regression with generalized estimating equations for both objectives, reporting unadjusted and adjusted odds ratios (AOR) with 95% confidence intervals (CIs).ResultsOver 18 months, 42.2% (202) reports of peer-led mobile outreach program use were made. High-risk women, including those servicing a higher weekly client volume (10+ compared to <10; AOR: 1.7, 95%CIs: 1.1-2.6) and those soliciting clients in deserted, isolated settings (AOR: 1.7, 95%CIs: 1.1-2.7) were more likely to use the program. In total, 9.4% (45) reports of using inpatient addiction treatment services were made (7.5% detoxification; 4.0% residential drug treatment), and 33.6% (161) using outpatient treatment (28.8% methadone; 9.6% alcohol/drug counsellor). Women who used the peer-led mobile outreach were more likely to use inpatient addiction treatment (AOR: 4.2, 95%CIs: 2.1-8.1), even after adjusting for drug use, environmental-structural factors, and outpatient drug treatment.DiscussionOur findings demonstrate that FSWs at higher risk for sexually transmitted infections and violence are more likely to access this peer-led mobile outreach program and suggest that the program plays a critical role in facilitating utilization of detoxification and residential drug treatment. |
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Keywords: | Mobile outreach Female sex workers Drug use HIV risk Addictions treatment |
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