Access to and acceptability of sexual and reproductive health, harm reduction and other essential health services among people who inject drugs in Durban, South Africa.

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE
Cecilia Milford, Tammany Cavanagh, Shannon Bosman, Michael Wilson, Jennifer Smit, Brian Zanoni
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Abstract

Background: People who inject drugs (PWID) are at risk of HIV acquisition. The number of PWID in South African cities is increasing, and in spite of an advanced HIV prevention and treatment programme, there are PWID who experience challenges accessing sexual and reproductive health (SRH) and HIV related services. Access to and acceptability of SRH and harm reduction services by PWID needs to be further understood and explored.

Methods: In-depth interviews (IDIs) were conducted with 10 key stakeholders and 11 PWID, in Durban, South Africa. Interviews were transcribed and translated. Data were thematically analysed using Dedoose software.

Results: Participants described stigma/discrimination from healthcare workers and other clients accessing services as barriers to accessing healthcare services. They were concerned about long waiting times at healthcare facilities because of possibilities of withdrawal, as well as lost opportunities to "hustle". Targeted, non-discriminatory services, as well as mobile clinics existed in the city. Non-governmental organisations reportedly worked together with the public sector, facilitating access to HIV and TB prevention and treatment services. There were also needle exchange programmes and a harm reduction clinic in the city. However, there was limited access to contraceptive and STI services. Although there was reportedly good access to HIV and TB and harm reduction services in the city of Durban, uptake was low.

Conclusions: The integration of services to enable PWID to access different services under one roof is critical. There is also a need to strengthen linkages between public and private healthcare, and ensure services are provided in a non-discriminatory environment. This will facilitate uptake and access to more comprehensive SRH and harm reduction services for PWID in Durban, South Africa.

南非德班注射吸毒者对性健康和生殖健康、减低伤害及其他基本保健服务的获取和接受程度。
背景:注射吸毒者(PWID)有感染艾滋病毒的风险。南非城市中的注射吸毒者人数在不断增加,尽管有先进的艾滋病预防和治疗计划,但仍有注射吸毒者在获得性健康和生殖健康(SRH)以及艾滋病相关服务方面遇到困难。我们需要进一步了解和探讨艾滋病感染者对性健康和生殖健康及减少伤害服务的获取和接受程度:在南非德班对 10 名主要利益相关者和 11 名艾滋病感染者进行了深入访谈(IDIs)。对访谈内容进行了誊写和翻译。使用 Dedoose 软件对数据进行了主题分析:结果:参与者认为,医疗工作者和其他服务对象的羞辱/歧视是获得医疗服务的障碍。他们担心在医疗机构等待的时间过长,因为有可能被撤回,也担心失去 "喧闹 "的机会。该市存在有针对性的非歧视性服务和流动诊所。据报告,非政府组织与公共部门合作,为获得艾滋病毒和结核病预防和治疗服务提供便利。该市还有针头交换方案和减少伤害诊所。然而,获得避孕和性传播感染服务的机会有限。据报道,虽然德班市的艾滋病毒和结核病防治服务以及减少伤害服务十分便利,但接受率却很低:结论:整合各种服务,使吸毒者能够在同一地点获得不同的服务至关重要。还需要加强公共和私人医疗保健之间的联系,并确保在无歧视的环境中提供服务。这将有助于南非德班的艾滋病感染者接受和获得更全面的性健康和生殖健康及减少伤害服务。
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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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