Objective: Prescription drug misuse (PDM) is an emerging epidemic in the United States. This study examines the prevalence and correlates of PDM among homeless men. Homeless men experience higher risk for substance misuse and associated health problems and are particularly vulnerable to PDM and its negative health consequences.
Methods: Participants were a representative probability sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Interviews assessed demographics, substance use, mental health, and social networks. Logistic regression examined correlates of PDM.
Results: Twenty-six percent of the study population reported PDM in the past year. PDM was more likely among homeless men suffering from posttraumatic stress disorder (PTSD) (odds ratio [OR] = 2.41, 95% confidence interval [CI]: 1.03-5.61) and among those with more substance-using social network members (OR = 1.07, 95% CI: 1.01-1.14). Decreased PDM was associated with good health (OR = 0.34, 95% CI: 0.16-0.75).
Conclusions: The prevalence of PDM is higher among the homeless men in this study than in the general population. Correlates of PDM included PTSD and poor health, suggesting that homeless men may use PDM to self-medicate. PDM was also associated with increased substance-using social network alters. Physical and mental health and social context are important aspects to consider in prevention efforts to reduce PDM among homeless men.
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http://dx.doi.org/10.1080/08897077.2012.726960 | DOI Listing |
Int J Equity Health
December 2024
Public Health Postgraduate Program, University of Brasilia, Brasilia, DF, Brazil.
Background: Most transgender people face different conditions of health vulnerability on a daily basis. In the Brazilian context, no research review has been found on such situations in the light of the theoretical conceptualization of multidimensional vulnerability. This research aimed to identify and analyze components of social and/or programmatic vulnerability that interfere with access to health care for trans people in Brazil.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
School of Social Work, University of Windsor, Windsor, Ontario, Canada.
Importance: Safer supply programs were implemented in Canada to provide pharmaceutical-grade alternatives to the toxic unregulated drug supply. While research shows clinical benefits and reduced overdose mortality among safer supply patients, medication diversion remains a concern.
Objective: To examine provider (prescribing clinicians and allied health professionals) and patient perspectives on diversion of opioids prescribed in safer supply programs.
Qual Health Res
December 2024
School of Nursing, University at Buffalo, State University of New York, Buffalo, NY, USA.
Although chronic health conditions and homelessness are prevalent problems in the United States and globally, little research has used the lens of burden of treatment theory to examine the experiences of people facing these challenges simultaneously. This study aimed to illuminate dimensions of treatment burden, which refers to the work of being a patient with chronic conditions, and patient capacity to manage this burden in a sample of people experiencing homelessness and chronic health problems in Buffalo, New York, United States. We completed in-depth interviews with men and women recruited from a homelessness services organization ( = 27) and applied core concepts from burden of treatment theory to our analysis to probe how participants navigated tasks related to treatment and self-care.
View Article and Find Full Text PDFAm J Epidemiol
November 2024
Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA.
During the COVID-19 pandemic, the sampling method for the National HIV Behavioral Surveillance (NHBS) in San Francisco changed from physical venue time-location sampling (TLS) to online or virtual venue TLS for men who have sex with men (MSM). We present differences in the samples of MSM recruited using physical venue TLS in 2017 and virtual venue TLS in 2021. We further assess changes in preventive and risk behaviors from 2017 to 2021 after controlling for differences in the sample compositions with multivariable Poisson models using GLM with robust standard errors.
View Article and Find Full Text PDFInt J Equity Health
November 2024
BC Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Introduction: Access to and engagement with primary healthcare can be difficult for marginalized low-income populations residing in inner cities in high-income countries. We designed a study to examine retention in primary care among clients of a novel interdisciplinary primary care clinic in the Downtown Eastside of Vancouver, Canada who did not previously have access to care.
Methods: Beginning in June 2021, clients of the Hope to Health clinic were offered enrolment in a cohort study which involved a baseline and follow-up surveys every six months, and linking their data to information from the clinic's electronic medical records.
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