High willingness to use overdose prevention sites among female sex workers in Baltimore, Maryland. (1st July 2020)

• Record Type: Journal Article
• Authors: Rouhani, Saba; White, Rebecca Hamilton; Park, Ju Nyeong; Sherman, Susan G.
• Is Part Of: Drug and alcohol dependence. Volume 212(2020)
• Publication Date: 2020-07-01
• Subjects: Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2020.108042
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Street-based female sex workers exhibit high willingness to use overdose prevention sites (OPS). Over half of women had experienced overdose in their lives. Overdose risk, homelessness and violence victimization were associated with higher willingness. Key barriers to use included transportation concerns and fear of police. OPS may be used to deliver other ancillary services (e.g., STI testing) to marginalized women. Abstract: Background: Overdose Prevention Sites (OPS) operate worldwide as spaces where people can consume previously purchased drugs under supervision, and are linked to reductions in HIV/HCV transmission and fatal overdoses. As the United States weighs their merits and legality, research is needed to estimate acceptability and use among populations at high risk for overdose. We examine willingness to use OPS among street-based female sex workers (FSW) with prevalent drug use and associated morbidities. Methods: We describe self-reported willingness, barriers and conditions around use of a hypothetical OPS among 141 FSW engaged in active drug use in Baltimore City, and describe trends using Pearson's χ2 and Fisher's exact tests. Results: Most women had history of overdose (55 %) and were likely to use OPS (77 %). Willingness was higher among women who: were sexual minorities (97 %; P= 0.002), experienced homelessness (82 %; P= 0.019), injected drugs (82 %; P= 0.013), shared syringes (82 %; P= 0.007), experienced sexual violence (92 %; P= 0.045) or reported heroin use (83 %; P= 0.039) in the past 3 months. Common anticipated barriers included transportation (45 %) and fear of arrest (41 %). Conclusions: This study highlights a population of uniquely high-risk women who would benefit from an OPS integrated with other services. Conditions and barriers discussed are informative for planning and implementation.