title: Opioid substitution therapy clients' preferences for targeted versus general primary health-care outlets.
abstract: OBJECTIVE
  Opioid substitution therapy (OST) ideally constitutes a window of opportunity for the provision of essential primary health care (PHC) for OST clients. In the absence of such opportunities, however, OST clients access PHC from existing outlets, either general services or those targeted to specific groups. This study examined OST clients' current main source and preferred future outlets of PHC services and correlates of preferences.
  
  
  METHODS
  Anonymous interviews conducted with n = 257 clients of two public OST clinics in Sydney's inner-west.
  
  
  RESULTS
  Overall, 61% (n = 158) of participants reported currently accessing PHC primarily from general outlets (general practitioners or medical centres: 51%, hospital/emergence departments: 10%) and the remainder (39%, n = 99) from outlets that target specific groups (e.g. Aboriginal Medical Services, OST prescriber/clinics, drug user-targeted PHCs). Twenty-two percent reported discomfort disclosing drug use to their current PHC providers. However, the majority were satisfied with the care they received and reported a preference to remain with their current PHC providers for a range of reasons, most commonly familiarity with and trust in staff (56%) and not feeling judged about their drug use (49%). Nevertheless, 28% reported that they would access PHC through their OST clinic if it were available.
  
  
  CONCLUSIONS
  PHC outlets that target specific groups appear to have an ongoing and important role in providing accessible health care to OST clients.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. mikhokan143@yahoo.com
authors.forename: M Mofizul
authors.initials: MM
authors.lastname: Islam
authors.forename: Libby
authors.initials: L
authors.lastname: Topp
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Conigrave
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Day
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods* / Q000523:psychology*; D057240:Patient Preference / Q000523:psychology*; D011320:Primary Health Care / Q000379:methods*; D057566:Self Report; D016320:Substance Abuse Treatment Centers / Q000379:methods*; D055815:Young Adult