title: Drug user treatment referrals and entry among participants of a needle exchange program.
abstract: OBJECTIVE
  To compare characteristics of needle exchange program (NEP) participants who requested methadone treatment to those who did not, compare participants who subsequently enrolled into treatment to those who did not enroll, and suggest possible barriers to treatment among NEP participants.
  
  
  METHODS
  Between 8/94 and 2/97, data pertaining to demographics and drug use were collected from Baltimore NEP participants upon registration. Participants were made aware that referrals to off-site methadone maintenance were available upon request. Odds ratios and multiple logistic regression models were used to compare those who requested treatment to those who did not and those who entered treatment to those who did not enter.
  
  
  RESULTS
  Among 2659 NEP participants, 86% were African-American, 28% were female, 9% were employed, and the median age was 38 years. Requesting a drug user treatment referral was associated with female gender [Adjusted Odds Ratio (AOR) = 2.02], age > 38 years (AOR = 1.96), use of speedballs during the past 6 months (AOR = 3.38), and age > 20 years at time of first injection (AOR = 1.59). Among 139 individuals who requested treatment, males were twice as likely as females to enter treatment (OR = 2.45). In an open-ended survey, health insurance (p = .02) and not living with children (p = .01) were associated with drug user treatment entry.
  
  
  CONCLUSIONS
  Even though female NEP participants were more likely to request methadone treatment, they were less likely than males to enter treatment. Although NEPs can be a bridge to drug user treatment, these data suggest that barriers to utilizing treatment referrals are important issues to resolve, especially for women who use community needle exchange programs.
authors.affiliation: University of California, Center for AIDS Prevention Studies, San Francisco, California, USA.
authors.forename: Elise D
authors.initials: ED
authors.lastname: Riley
authors.forename: Mahboobeh
authors.initials: M
authors.lastname: Safaeian
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Robert K
authors.initials: RK
authors.lastname: Brooner
authors.forename: Peter
authors.initials: P
authors.lastname: Beilenson
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000293:Adolescent; D000328:Adult; D015142:Baltimore; D003710:Demography; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D018671:Needle-Exchange Programs; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012017:Referral and Consultation; D012042:Registries; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000628:therapy*; D011795:Surveys and Questionnaires
chemical_list: D008691:Methadone