Sex work involvement among women with longterm opioid injection drug dependence who enter opioid agonist treatment

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dc.contributor.authorMarchand, Kirsten
dc.contributor.authorOviedo-Joekes, Eugenia
dc.contributor.authorGuh, Daphne
dc.contributor.authorMarsh, David C.
dc.contributor.authorBrissette, Suzanne
dc.contributor.authorSchechter, Martin T
dc.date.accessioned2014-01-07T23:27:07Z
dc.date.available2014-01-07T23:27:07Z
dc.date.copyright2012en_US
dc.date.issued2012-01-25
dc.descriptionBioMed Centralen_US
dc.description.abstractBackground: Substitution with opioid-agonists (e.g., methadone) has shown to be an effective treatment for chronic long-term opioid dependency. Survival sex work, very common among injection drug users, has been associated with poor Opioid Agonist Treatment (OAT) engagement, retention and response. Therefore, this study was undertaken to determine factors associated with engaging in sex work among long-term opioid dependent women receiving OAT. Methods: Data from a randomized controlled trial, the North American Opiate Medication Initiative (NAOMI), conducted in Vancouver and Montreal (Canada) between 2005-2008, was analyzed. The NAOMI study compared the effectiveness of oral methadone to injectable diacetylmorphine or injectable hydromorphone, the last two on a double blind basis, over 12 months. A research team, independent of the clinic services, obtained outcome evaluations at baseline and follow-up (3, 6, 9, 12, 18 and 24 months). Results: A total 53.6% of women reported engaging in sex work in at least one of the research visits. At treatment initiation, women who were younger and had fewer years of education were more likely to be engaged in sex work. The multivariate logistic generalized estimating equation regression analysis determined that psychological symptoms, and high illicit heroin and cocaine use correlated with women’s involvement in sex work during the study period. Conclusions: After entering OAT, women using injection drugs and engaging in sex work represent a particularly vulnerable group showing poorer psychological health and a higher use of heroin and cocaine compared to women not engaging in sex work. These factors must be taken into consideration in the planning and provision of OAT in order to improve treatment outcomes. Trial Registration: NCT00175357.en_US
dc.description.reviewstatusRevieweden_US
dc.description.scholarlevelFacultyen_US
dc.description.sponsorshipThe study was funded through an operating grant by the Canadian Institutes of Health Research (CIHR) with additional support from the Canada Foundation for Innovation, the Canada Research Chairs Program, the University of British Columbia, Providence Health Care, the University of Montreal, Centre de Recherche et Aide aux Narcomanes, the Government of Quebec, Vancouver Coastal Health Authority and the BC Centre for Disease Control. CIHR had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.en_US
dc.identifier.citationMarchand et al.: Sex work involvement among women with long-term opioid injection drug dependence who enter opioid agonist treatment. Harm Reduction Journal 2012 9:8.en_US
dc.identifier.urihttp://www.harmreductionjournal.com/content/9/1/8
dc.identifier.urihttp://dx.doi.org/10.1186/1477-7517-9-8
dc.identifier.urihttp://hdl.handle.net/1828/5144
dc.language.isoenen_US
dc.publisherBioMed Centralen_US
dc.subjectCanadian Institute for Substance Use Research
dc.subjectSex work
dc.subjectopioid dependence
dc.subjectsubstitution treatment
dc.titleSex work involvement among women with longterm opioid injection drug dependence who enter opioid agonist treatmenten_US
dc.typeArticleen_US

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