Search

Longitudinal cohort studies are important for understanding the social and health trajectories of people who inject drugs. Little research exists, however, about the motivations, challenges, and experiences of participation in these studies. To address this gap, we conducted in-depth interviews with participants of an open-ended natural history longitudinal cohort study (SuperMIX) and with fieldworkers who collect the data for this study. Interviews were audio-recorded, and data analyzed thematically. Research findings revealed several motivating factors that encouraged participants to get involved in and stay in the study including financial reimbursement and the opportunity to contribute to a study aiming to improve the lives of peers. Many participants discussed their appreciation of the kindness and respect they were afforded by fieldworkers, and the advocacy role fieldworkers had undertaken with them. While some participants described challenges responding to some questions, there were also expressions of finding the experience therapeutic. Findings provide learnings for future studies and highlight how participation in longitudinal cohort research can provide an opportunity for on-going engagement that affords participants not only a chance to share their experiences, but to contribute to knowledge production and achieve clarity about their own experience. [ABSTRACT FROM AUTHOR]

Background: Australian harm reduction services are provided via a mix of modalities, including fixed-site needle and syringe programmes (NSP) and syringe-dispensing machines (SDMs). SDMs are cost-effective and provide 24-h anonymous access to needles/syringes, often to underserved geographic areas, and can attract clientele who may choose not to use NSPs. The introduction of COVID-19 control measures saw disruptions and adaptations to the provision of harm reduction services. It is possible that SDMs filled the gap in otherwise disrupted harm reduction services in Melbourne. In this paper, we use data from four SDMs and an NSP to explore changes to harm reduction usage during periods of COVID-19 lockdowns in Melbourne, Australia, in 2020. Methods: Our data span September 2017–December 2020. We analysed daily counts of SDM use and monthly counts of NSP use, according to unique presentations to both. Auto-regressive integrated moving average (ARIMA) time-series models were fitted to the data with the effects of lockdowns estimated via a step function. Results: Across the study period, we estimated 85,851 SDM presentations and 29,051 NSP presentations. Usage across both the SDMs and the NSP declined during the COVID-19 lockdowns, but only the decline in SDM usage was significant in ARIMA analysis. Conclusions: The slight, but significant decline in SDM use suggests barriers to access, though this may have been mitigated by SDM users acquiring needles/syringes from other sources. The decline, however, may be a concern if it led to lowered needle/syringe coverage and a subsequent increase in injecting risk. Further work is needed to properly explore potential changes in preference for needle/syringe acquisition site and associated barriers. Importantly, this work adds to the body of literature around the impacts of COVID-19 on harm reduction provision and potential areas of improvement. [ABSTRACT FROM AUTHOR]

Background: Community reintegration from prison is typically stressful, with several health and social outcomes impacting psychiatric well-being during this time, often exacerbated among individuals with histories of drug use. Longitudinal data was used to assess change in psychiatric well-being over 2 years following release from prison among men who reported a recent history of injecting drug use. Methods: Data for this study come from the Prison and Transition Health cohort study of 400 men recruited in prison prior to release and followed up over three time points. Psychiatric well-being was assessed using the 12-item General Health Questionnaire. We calculated change in individual General Health Questionnaire scores between interviews and identified covariates associated with General Health Questionnaire score using linear mixed-effects regression. Results: Data from 690 follow-up interviews among 326 participants were included in analyses. There was considerable variation in individuals' General Health Questionnaire scores. Moving accommodation frequently and frequent illicit drug injections were associated with an increase in General Health Questionnaire score (i.e. decline in psychiatric well-being). Two or more prior adult imprisonment episodes, social supports and past month primary healthcare attendance were associated with a decrease in General Health Questionnaire score. Conclusion: Our findings identify health, social and structural influences on psychiatric well-being after release from prison that can inform re-entry programmes to support community reintegration. [ABSTRACT FROM AUTHOR]

Introduction and Aims: Limited research has investigated methamphetamine use and related harms in rural and regional Australia. We investigated whether people who used methamphetamine in non‐metropolitan Victoria differed in their sociodemographics and were more likely to be methamphetamine‐dependent than those recruited in Melbourne. Design and Methods: We used baseline data from an ongoing prospective cohort study, 'VMAX'. Participants were recruited from Melbourne and three non‐metropolitan Victorian regions. Sequential multivariable logistic regression of nested models assessed unadjusted and adjusted associations between residential locations and methamphetamine dependence. Results: The sample mostly (77%) comprised people who used methamphetamine via non‐injecting means (N = 744). Thirty‐nine percent were female. Melbourne‐based participants were less likely than non‐metropolitan participants to identify as Aboriginal and Torres Strait Islander, be heterosexual, have children and be unemployed. More frequent methamphetamine use (adjusted odds ratio 1.22, 95% confidence interval 1.12–1.34) and using crystal methamphetamine versus 'speed' powder (adjusted odds ratio 2.38, 95% confidence interval 1.26–3.64) were independently (P < 0.05) associated with being classified as methamphetamine‐dependent. A significantly higher percentage of participants in every non‐metropolitan region were classified as methamphetamine‐dependent vs. those in Melbourne, but this relationship was attenuated when adjusting for methamphetamine use frequency and primary form used. Despite 65% of participants being classified as methamphetamine‐dependent, less than half had recently (past year) accessed any professional support for methamphetamine, with minimal variation by recruitment location. Discussions and Conclusions: VMAX participants in non‐metropolitan Victoria were more likely to be methamphetamine‐dependent than those living in Melbourne. Unmet need for professional support appears to exist among people using methamphetamine across the state, regardless of geographical location. [ABSTRACT FROM AUTHOR]