Removing barriers to care: The importance of addressing nonfatal overdoses among women living with HIV in British Columbia, Canada.

Abstract

The overdose and drug toxicity crisis continues to devastate communities across Canada. British Columbia has an overdose mortality rate nearly double the Canadian national average, emphasizing a dire need for proactive public health approaches. Within the general population, men experience higher overdose mortality rates in comparison to women; however, among people with HIV, the disparity is inverted such that women with HIV experience higher overdose mortality rates than men with HIV. Less is known concerning the epidemiology of nonfatal overdoses among people with HIV, and understanding gender disparities in nonfatal overdoses would allow public health practitioners and policymakers to focus evidence-informed interventions and clinical guidelines for people most in need. In this commentary, we propose that systemic and structural barriers function to hinder access to crucial services for women with HIV, thus placing them at a disproportionately high risk for nonfatal overdose. We argue that additional research is needed to understand how to completely address these barriers in order to create programmatic changes. Fatal overdoses are a failure of the healthcare system; intervening after the occurrence of a nonfatal overdose is crucial in order to prevent a subsequent fatal overdose.