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The association between experiencing discrimination and physical and mental health among people who inject drugs [2018]

Background
Discrimination can be a daily issue in the lives of people who inject drugs (PWID). However, the extent to which discrimination is related to the health of PWID remains unclear.

Methods
Data focusing on discrimination against PWID and potential health correlates were collected as part of the 2013 Illicit Drug Reporting System, a national survey with 887 PWID recruited in all Australian states and territories. Experience of discrimination, its setting, perceived reason and outcome, were self-reported by participants. The Kessler-10 scale and the mental component score of the Short Form 12-Item Health Survey were used to measure mental health. Physical health was assessed using the physical component score of the Short Form 12-Item Health Survey, specifically questions assessing injecting related problems and risk behaviour. Poisson and multinomial regression analyses were performed. Models were adjusted for socio-demographic and drug-related covariates.

Findings
PWID reported experiencing discrimination in pharmacies, hospitals, government services and doctors/prescribers. The most commonly reported instances of discrimination were being refused service and experiencing abuse and/or violence. Experience of discrimination was associated with mental and physical health indicators. PWID who experienced discrimination were more likely to report high or very high mental distress (ARRR = 2.4, CI95 = 1.5–3.6) and mental health problems (ARRR = 1.4, CI95 = 1.2–1.7). The mental functioning (ARRR = 1.3, CI95 = 1.1–1.4) and physical functioning (ARRR = 1.1, CI95 = 1.1–1.4) of PWID, who experienced discrimination, were also more likely to be below Australian population mean scores.

Conclusion
Self-reported experience of discrimination was associated with poor mental and physical health amongst PWID.

Camila Couto e Cruz, Caroline L. Salom, Paul Dietze, Lucinda Burns, Rosa Alati
International Journal of Drug Policy, Volume 65, March 2019
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