Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020-2021: a cross-sectional study.

Autor: Calderón-Villarreal A; Department of Family and Preventive Medicine, University of California San Diego (UCSD), San Diego, California, USA. acv001@health.ucsd.edu.; School of Public Health, San Diego State University (SDSU), San Diego, California, USA. acv001@health.ucsd.edu., Avelar Portillo LJ; Benioff Homelessness and Housing Initiative, School of Medicine, University of California, San Francisco, California, USA.; Division of Global Health, Herbert Wertheim School of Public Health and Human Longevity Science, UCSD, San Diego, California, USA., Abramovitz D; Department of Medicine, Division of Infectious Diseases and Global Public Health, UCSD, San Diego, California, USA., Goldenberg S; School of Public Health, San Diego State University (SDSU), San Diego, California, USA., Flanigan S; School of Public Affairs, SDSU, San Diego, California, USA., Quintana PJE; School of Public Health, San Diego State University (SDSU), San Diego, California, USA., Harvey-Vera A; Department of Medicine, Division of Infectious Diseases and Global Public Health, UCSD, San Diego, California, USA.; Universidad de Xochicalco, Tijuana, Baja California, Mexico., Vera CF; Department of Medicine, Division of Infectious Diseases and Global Public Health, UCSD, San Diego, California, USA., Rangel G; El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico.; Border Health Commission, Tijuana, Baja California, Mexico., Strathdee SA; Department of Medicine, Division of Infectious Diseases and Global Public Health, UCSD, San Diego, California, USA., Kayser GL; Benioff Homelessness and Housing Initiative, School of Medicine, University of California, San Francisco, California, USA.
Jazyk: angličtina
Zdroj: International journal for equity in health [Int J Equity Health] 2024 Apr 22; Vol. 23 (1), pp. 79. Date of Electronic Publication: 2024 Apr 22.
DOI: 10.1186/s12939-024-02163-x
Abstrakt: Background: Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area.
Methods: In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020-2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates.
Results: Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02-2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28-1.64), and bathing (aRR: 1.21, 95%CI: 1.06-1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07-3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52-2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55-6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36-4.89) than participants living in permanent housing.
Conclusion: WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID-especially those who are unsheltered.
(© 2024. The Author(s).)
Databáze: MEDLINE
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