title: Risk behaviours and healthcare needs of homeless drug users in Saint Lucia and Trinidad.
abstract: In the Caribbean AIDS has become the leading cause of death among those aged 15-45. The homeless are at high risk due to the nexus of mobility, psychiatric disorders and substance use, particularly crack. Seventy-four homeless, out-of-treatment drug users were recruited in Saint Lucia and Trinidad to assess risk behaviour and healthcare needs. Information was collected in several domains: medical, mental health, substance use, sexual risk, and barriers to care. Ninety-five percent of the sample reported crack cocaine use within the previous 30 days. Approximately 35% of the sample had ever been diagnosed with a sexually transmitted disease and 25% of the sample reported being HIV+. Approximately 40% had a history of trading sex for crack or money. Due to the range of needs in this population, interventions should be multimodal. A focus on the individual, community, and structural levels is warranted to improve chances of program effectiveness.
authors.affiliation: Caribbean Drug Abuse Research Institute, Castries, Saint Lucia.
authors.forename: Marcus
authors.initials: M
authors.lastname: Day
authors.forename: Jessy G
authors.initials: JG
authors.lastname: Devieux
authors.forename: Sandra D
authors.initials: SD
authors.lastname: Reid
authors.forename: Dionne J
authors.initials: DJ
authors.lastname: Jones
authors.forename: Joseph
authors.initials: J
authors.lastname: Meharris
authors.forename: Robert M
authors.initials: RM
authors.lastname: Malow
mesh_terms: D000328:Adult; D001294:Attitude to Health; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities; D006703:Ill-Housed Persons / Q000193:education / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D020380:Needs Assessment / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration; D012309:Risk-Taking; D019431:Saint Lucia / Q000453:epidemiology; D011477:Sex Work / Q000523:psychology / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014300:Trinidad and Tobago / Q000453:epidemiology; D014505:Urban Population