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A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives

May, T; Dawes, J; Fancourt, D; Burton, A; (2022) A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives. MedRxiv: Cold Spring Harbor, NY, USA. Green open access

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Abstract

Background: People Who Inject Drugs (PWID) are subject to distinct socio-structural inequalities that can expose them to high risks of COVID –19 transmission and related health and social complications. In response to COVID –19 mitigation strategies, these vulnerabilities are being experienced in the context of adapted drug treatment service provision, including reduced in–person support and increased regulatory flexibility in opioid substitution therapy (OST) guidelines. This study aimed to explore the longer–term impact of the pandemic on the health and wellbeing of PWID, including provider and client experiences of treatment changes. / Methods: Interviews were conducted with 19 PWID and 17 drug treatment providers between May – September 2021, recruited from third –sector drug services in the UK. Data were analysed using reflexive thematic analysis. / Results: Most participants expressed ongoing fears of COVID –19 transmission, although socio-structural inequalities limited the contexts in which physical distancing could be practised. In addition, virus mitigation strategies altered the risk environment for PWID, resulting in ongoing physical (e.g. drug use patterns and characteristics), economic (e.g. sex work engagement and income generation) and social (e.g. stigmatization and marginalization) harms. Finally, whilst clients reported favourable experiences from service adaptations prompted by COVID –19, there was continued scepticism and caution among providers toward sustaining any treatment changes beyond the pandemic period. / Conclusions: Whilst our findings emphasize the importance of accessible support measures attending to the immediate priorities of PWID during this period, there is a need for additional supports to ensure socio–structural vulnerabilities that disproportionality affect PWID are not exacerbated by the pandemic. In addition, treatment adaptations initiated in response to the pandemic require further attention to ensure they are acceptable to both clients and providers.

Type: Working / discussion paper
Title: A qualitative study exploring the impact of the COVID-19 pandemic on People Who Inject Drugs (PWID) and drug service provision in the UK: PWID and service provider perspectives
Open access status: An open access version is available from UCL Discovery
DOI: 10.1101/2022.01.24.22269530
Publisher version: https://doi.org/10.1101/2022.01.24.22269530
Language: English
Additional information: The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery.ucl.ac.uk/id/eprint/10142495
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