Characteristics of women initiated on opioid substitution therapy at primary health care level in Tshwane, South Africa

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Stellenbosch : Stellenbosch University
ENGLISH SUMMARY: Background: Women who use drugs (WWUD) face specific challenges compared to men, such as higher rates of HIV infection, unsafe injecting practices, and intimate partner violence. However, this population's access to treatment and gender-sensitive interventions remains limited, leading to unmet needs and increased vulnerability. Aim: To investigate the characteristics of WWUD accessing opioid substitution therapy (OST) services in primary health care, with the goal of informing gender-sensitive services. Setting: The Community Orientated Substance Use Programme (COSUP) Tshwane, South Africa. Methods: This descriptive observational study included all 199 adult women with an opioid use disorder who received OST from COSUP in 2016-2022. Existing data were extracted from an electronic database and paper-based files. Data was analysed with the Statistical Package of Social Sciences and associations of variables with retention on OST for ≥6 months were analysed. Results: Participants were unemployed, most falling within the 20-29 years age range and accessing services from community based facilities. One in three women had experienced intimate partner violence and 19.0% were pregnant whilst on OST. Retention on OST was significantly associated with age at initiation (p=0.047), knowledge of HIV status (p=0.029), an increase in the ASSIST score (r=0.171, p=0.023), and methadone dose (r=0.339, p<0.001). Factors such as race, employment status, health system level, pregnancy, intimate partner using substances, intimate partner violence, route of administering opioids, and having tuberculosis and/or hepatitis C infection did not show a significant relationship with retention on OST (p>0.05). Conclusion: The study emphasises the intersectionality of substance use harms and retention on OST, calling for further research and the implementation of comprehensive interventions in harm reduction programs providing OST.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.
Thesis (MFamMed)--Stellenbosch University, 2023.