Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
BackgroundAccess to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1224376/full |
| _version_ | 1797776073409167360 |
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| author | Rosalind Gittins Joseph Tay Wee Teck Joseph Tay Wee Teck Rebecca Knowles Nicole Clarke Alexander Baldacchino |
| author_facet | Rosalind Gittins Joseph Tay Wee Teck Joseph Tay Wee Teck Rebecca Knowles Nicole Clarke Alexander Baldacchino |
| author_sort | Rosalind Gittins |
| collection | DOAJ |
| description | BackgroundAccess to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagement that permitted opportunities to meet their healthcare or housing needs. Barriers to accessing care provision include an itinerant lifestyle, difficulties with travel at unpredictable hours, impacting upon adherence to medication regimens including daily supervised consumption.ObjectivesTo use a co-produced, “health at the margins” approach, to reach the sex-working population in Leeds, and support informed choices about the potential to receive buprenorphine prolonged-release injection (BPRI) as a treatment option for OUD.MethodsBPRI was introduced using a theory of change model and improvements in sex-worker care delivery was reviewed. Strategies included buprenorphine micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based and trauma-informed approach.ResultsBenefits of BPRI included removal of the need for daily pharmacy visits, reducing the risk of diversion, improved medication adherence, stability and engagement with treatment and supportive services.ConclusionBPRI may offer an additional option for pharmacological interventions for people with OUD where there may be increased barriers to accessing treatment for example due to sex-working. Strategies for effective BPRI include micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based approach. |
| first_indexed | 2024-03-12T22:44:45Z |
| format | Article |
| id | doaj.art-f41545c75b5241ada8059781460f831b |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-03-12T22:44:45Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-f41545c75b5241ada8059781460f831b2023-07-21T08:24:35ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-07-011410.3389/fpsyt.2023.12243761224376Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workersRosalind Gittins0Joseph Tay Wee Teck1Joseph Tay Wee Teck2Rebecca Knowles3Nicole Clarke4Alexander Baldacchino5Via, London, United KingdomForward Leeds and Humankind Charity, Durham, United KingdomPopulation and Behavioural Science Research Division, School of Medicine, St Andrews University, St Andrews, United KingdomForward Leeds and Humankind Charity, Durham, United KingdomForward Leeds and Humankind Charity, Durham, United KingdomPopulation and Behavioural Science Research Division, School of Medicine, St Andrews University, St Andrews, United KingdomBackgroundAccess to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagement that permitted opportunities to meet their healthcare or housing needs. Barriers to accessing care provision include an itinerant lifestyle, difficulties with travel at unpredictable hours, impacting upon adherence to medication regimens including daily supervised consumption.ObjectivesTo use a co-produced, “health at the margins” approach, to reach the sex-working population in Leeds, and support informed choices about the potential to receive buprenorphine prolonged-release injection (BPRI) as a treatment option for OUD.MethodsBPRI was introduced using a theory of change model and improvements in sex-worker care delivery was reviewed. Strategies included buprenorphine micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based and trauma-informed approach.ResultsBenefits of BPRI included removal of the need for daily pharmacy visits, reducing the risk of diversion, improved medication adherence, stability and engagement with treatment and supportive services.ConclusionBPRI may offer an additional option for pharmacological interventions for people with OUD where there may be increased barriers to accessing treatment for example due to sex-working. Strategies for effective BPRI include micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based approach.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1224376/fulloutreachsex-worktrauma-informedbuprenorphinemicro-induction |
| spellingShingle | Rosalind Gittins Joseph Tay Wee Teck Joseph Tay Wee Teck Rebecca Knowles Nicole Clarke Alexander Baldacchino Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers Frontiers in Psychiatry outreach sex-work trauma-informed buprenorphine micro-induction |
| title | Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers |
| title_full | Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers |
| title_fullStr | Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers |
| title_full_unstemmed | Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers |
| title_short | Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers |
| title_sort | implementing buprenorphine prolonged release injection using a health at the margins approach for transactional sex workers |
| topic | outreach sex-work trauma-informed buprenorphine micro-induction |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1224376/full |
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