Guide to Creative Commons for Humanities and Social Science Monograph Authors

An output of the OAPEN-UK project, this guide explores concerns expressed in public evidence given by researchers, learned societies and publishers to inquiries in the House of Commons and the House of Lords, and also concerns expressed by researchers working with the OAPEN-UK project. We have also identified a number of common questions and have drafted answers, which have been checked by experts including Creative Commons. The guide has been edited by active researchers, to make sure that it is relevant and useful to academics faced with making decisions about publishing

Increasing Availability of Illicit and Prescription Opioids among People who Inject Drugs in a Canadian Setting, 2010-2014

Background: The increase over the past decade in the non-medical use of prescription opioids and illicit opioids in North America has resulted in significant health-related harms.Objective: We sought to examine temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada.Methods: Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen) or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone). We defined perceived availability as immediate (e.g., available within 10 minutes) vs. no availability/available after 10 minutes. The trend and correlation of immediate availability were identified by multivariable generalized estimating equations logistic regression.Results: Among 1584 participants, of which 564 (35.6%) were female, the immediate availability of all illicit and prescribed opioids (except for oxycontin/OxyNEO) increased over time, independent of potential confounders. The Adjusted Odds Ratios of immediate availability associated with every calendar year increase were between 1.09 (95% confidence interval 1.05-1.12) (morphine and Dilaudid) and 1.13 (95% confidence interval 1.09-1.17) (Percocet/Vicodin/Demerol) (all p-values <0.05).Conclusion: The availability of most prescription opioids had continued to increase in recent years among our sample of PWID in Vancouver. Concurrent increases in the availability of heroin were also observed, raising concerns regarding combination of both illicit and prescription opioids use among PWID that could potentially increase the risk of overdose

Increasing Availability of Benzodiazepines Among People Who Inject Drugs in a Canadian Setting

Background: Benzodiazepine misuse is associated with mortality and is common among people who inject drugs (PWID). This study aimed to examine the temporal trends in the availability of benzodiazepines among PWID in a Canadian setting, and to identify factors associated with more immediate access to benzodiazepines. Methods: Data were derived from three prospective cohorts of PWID in Vancouver, Canada, between June 2012 and May 2015. The primary outcome was the perceived availability of benzodiazepines, measured in three levels: not available, delayed availability (available in ≥10 min), and immediate availability (available in <10 min). We used multivariable generalized estimating equations to identify factors associated with availability of benzodiazepines. Results: In total, 1641 individuals were included in these analyses. In multivariable analyses, factors associated with immediate benzodiazepine availability included incarceration (adjusted odds ratio (AOR): 1.42, 95% CI1.06, 1.89) and participation in methadone maintenance therapy (MMT) (AOR: 1.35, 95% CI 1.14, 1.60). Factors associated with delayed benzodiazepine availability included incarceration (AOR: 1.45, 95% CI 1.02, 2.07) and MMT (AOR: 1.77, 95% CI 1.48, 2.12). Benzodiazepine availability increased throughout the study period for both immediate (AOR: 1.14, 95% CI 1.10, 1.18 per 6-month follow-up period) and delayed availability (AOR: 1.17, 95% CI 1.12, 1.22 per 6-month follow-up period). Conclusions: Among our sample of PWID, benzodiazepine availability is increasing and was associated with health and criminal justice system characteristics. Our findings indicate a need to examine prescribing practices and educate both PWID and healthcare providers about the risks associated with benzodiazepine use

The Impact of Methadone Maintenance Therapy on Access to Regular Physician Care Regarding Hepatitis C Among People who Inject Drugs

Background & aims People who inject drugs (PWID) living with hepatitis C virus (HCV) infection often experience barriers to accessing HCV treatment and care. New, safer and more effective directacting antiviral-based therapies offer an opportunity to scale-up HCV-related services. Methadone maintenance therapy (MMT) programs have been shown to be effective in linking PWID to health and support services, largely in the context of HIV. The objective of the study was to examine the relationship between being enrolled in MMT and having access to regular physician care regarding HCV among HCV antibody-positive PWID in Vancouver, Canada

Patterns of social determinants of health associated with drug use among women living with HIV in Canada: a latent class analysis

Background and AimsIdentifying typologies of social determinants of health (SDoH) vulnerability influencing drug use practices among women living with HIV (WLWH) can help to address associated harms. This research aimed to explore the association of SDoH clusters with drug use among WLWH.DesignLatent class analysis (LCA) was used to identify the distinct clusters of SDoH. Inverse probability weighting (IPW) was employed to account for confounding and potential selection bias. Associations were analyzed using generalized linear model with log link and Poisson distribution, and then weighted risk ratio (RR) and 95% confidence intervals (CI) were reported.Setting and ParticipantsData from 1422 WLWH recruited at timeâ point 1 of the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS, 2013â 15), with 1252 participants at 18 months followâ up (timeâ point 2).MeasurementsDrug use was defined as use of illicit/nonâ prescribed opioids/stimulants in the past 6 months. SDoH indicators included: race discrimination, gender discrimination, HIV stigma, social support, access to care, food security, income level, employment status, education, housing status and histories of recent sex work and incarceration.FindingsLCA identified four SDoH classes: no/least SDoH adversities (6.6%), discrimination/stigma (17.7%), economic hardship (30.8%) and most SDoH adversities (45.0%). Drug use was reported by 17.5% and 17.2% at timeâ points 1 and 2, respectively. WLWH with no/least SDoH adversities were less likely to report drug use than those in economic hardship class (weighted RR = 0.13; 95% CIs = 0.03, 0.63), discrimination/stigma class (weighted RR = 0.15; 95% CIs = 0.03, 0.78), and most SDoH adversities class (weighted RR = 0.13; 95% CIs = 0.03, 0.58).ConclusionsSocial determinants of health vulnerabilities are associated with greater likelihood of drug use, underscoring the significance of addressing interlinked social determinants and drug use through the course of HIV care and treatment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149504/1/add14566_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149504/2/add14566.pd

Workplace Violence among Female Sex Workers Who Use Drugs in Vancouver, Canada: Does Client Targeted Policing Increase Safety?

Workplace violence, by clients or predators, poses serious negative health consequences for sex workers. In 2013, the Vancouver (British Columbia), Canada Police Department changed their guidelines with the goal of increasing safety for sex workers by focusing law enforcement on clients and third parties, but not sex workers. We sought to examine the trends and correlates of workplace violence among female sex workers (FSW) before and after the guideline change, using data collected from prospective cohorts of persons who use illicit drugs in Vancouver, Canada. Among 259 FSW, 21.0% reported workplace violence at least once during the study period between 2008 and 2014. There was no statistically significant change in rates of workplace violence after the guideline change. In our multivariable analysis, daily heroin use was independently associated with workplace violence. The 2013 policing guideline change did not appear to have resulted in decreased reports of workplace violence. Increased access to opioid agonist therapies may reduce workplace violence among drug-using FSW

HIV Serostatus and Having Access to a Physician for Regular Hepatitis C Virus Care Among People Who Inject Drugs

Background: People who inject drugs (PWID) and who are living with HIV and hepatitis C virus (HCV) infection are vulnerable to a range of health-related harms, including liver cirrhosis, hepatocellular carcinoma, and death. There is limited evidence describing how HIV serostatus shapes access to a physician for regular HCV care among PWID

Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

The burden of HIV/AIDS and other transmissible diseases is higher in prison and jail settings than in the non-incarcerated communities that surround them. In this comprehensive review, we discuss available literature on the topic of clinical management of people infected with HIV, hepatitis B and C viruses, and tuberculosis in incarcerated settings in addition to co-occurrence of one or more of these infections. Methods such as screening practices and provision of treatment during detainment periods are reviewed to identify the effect of community-based treatment when returning inmates into the general population. Where data are available, we describe differences in the provision of medical care in the prison and jail settings of low-income and middle-income countries compared with high-income countries. Structural barriers impede the optimal delivery of clinical care for prisoners, and substance use, mental illness, and infectious disease further complicate the delivery of care. For prison health care to reach the standards of community-based health care, political will and financial investment are required from governmental, medical, and humanitarian organisations worldwide. In this review, we highlight challenges, gaps in knowledge, and priorities for future research to improve health-care in institutions for prisoners

Food insecurity during the COVID-19 pandemic among people who use drugs in Vancouver, Canada

Abstract Objective: To examine prevalence and factors associated with food insecurity among people who use drugs (PWUD) during the first year of the COVID-19 pandemic and the overdose crisis. Design: This cross-sectional study employs multivariable logistic regression to identify factors associated with self-reported food insecurity. Participants: PWUD who are part of three community-recruited cohorts. Setting: Interviews conducted in Vancouver, Canada via phone between July-November 2020 in adherence to COVID-19 safety procedures. Results: Among 765 participants, including 433 (56.6%) men, eligible for this study, 146 (19.1%; 95% confidence interval [CI]: 16.3%-21.9%) reported food insecurity in the past month. Of the participants reporting food insecurity, 114 (78.1%) reported that their hunger levels had increased since the beginning of the pandemic. In multivariable analyses, factors independently and positively associated with food insecurity included: difficulty accessing health or social services (adjusted odds ratio [AOR]=2.59; 95% CI: 1.60-4.17); having mobility difficulties (AOR=1.59; 95% CI: 1.02-2.45); and engaging in street-based income generation (e.g., panhandling and informal recycling) (AOR=2.31; 95% CI: 1.45-3.65). Conclusion: Approximately one in five PWUD reported food insecurity during this time. PWUD with mobility issues, who experienced difficulty accessing services, and/or those engaged in precarious street-based income generation were more likely to report food insecurity. Food security is paramount to the success of interventions to prevent COVID-19 and drug toxicity deaths. These findings suggest a need for a more unified state response to food insecurity that prioritizes and incorporates accessibility and autonomy of the communities they serve