In the U.S. and Canada, people who inject drugs’ (PWID) enrollment in medication-assisted treatment (MAT) has been associated with a reduced likelihood that they will assist others in injection initiation events. We aimed to qualitatively explore PWID’s experiences with MAT and other drug treatment and related recovery services in Tijuana Mexico, a resource-limited setting disproportionately impacted by injection drug use. PReventing Injecting by Modifying Existing Responses (PRIMER) seeks to assess socio-structural factors associated with PWID provision of injection initiation assistance. This analysis drew on qualitative data from Proyecto El Cuete (ECIV), a Tijuana-based PRIMER-linked cohort study. In-depth qualitative interviews were conducted with a subset of study participants to further explore experiences with MAT and other drug treatment services. Qualitative thematic analyses examined experiences with these services, including MAT enrollment, and related experiences with injection initiation assistance provision. At PRIMER baseline, 607(81.1%) out of 748 participants reported recent daily IDU, 41(5.5%) reported recent injection initiation assistance, 92(12.3%) reported any recent drug treatment or recovery service access, and 21(2.8%) reported recent MAT enrollment (i.e., methadone). Qualitative analysis (n?=?21; female?=?8) revealed that, overall, abstinence-based recovery services did not meet participants’ recovery goals, with substance use-related social connections in these contexts potentially shaping injection initiation assistance. Themes also highlighted individual-level (i.e., ambivalence and MAT-related stigma) and structural-level (i.e., cost and availability) barriers to MAT enrollment. Tijuana’s abstinence-based drug treatment and recovery services were viewed as unable to meet participants’ recovery-related goals, which could be limiting the potential benefits of these services. Drug treatment and recovery services, including MAT, need to be modified to improve accessibility and benefits, like preventing transitions into drug injecting, for PWID.
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机译：在美国和加拿大，注射药物（PWID）中的人们在药物辅助治疗（MAT）中的入学人员已经与减少的可能性有关，使其能够在注射启动事件中提供帮助。我们旨在定性地探索PWID在Tijuana墨西哥的席克和其他药物治疗和相关恢复服务的经验，这是一种由注射药物使用不成比例地影响的资源限制。通过修改现有响应（底漆）防止注射旨在评估与PWID提供注射启动辅助相关的社会结构因素。该分析从Proyecto El Cuete（ECIV）的定性数据提高了一种基于蒂华纳的底漆联系的队列研究。深入的定性访谈是通过研究参与者的一部分进行的，以进一步探索垫和其他药物治疗服务的经验。定性专题分析检查了这些服务的经验，包括席克入学率和注射启动援助的相关经验。在底漆基线，748名参与者中的607名（81.1％）报告最近的每日IDU，41（5.5％）报告最近的注射发起援助，92名（12.3％）报告了最近的任何药物治疗或恢复服务接入，21（2.8％）报告最近的乳头注册（即美沙酮）。定性分析（n？= 21;女性？=？8）透露，总体而言，基于禁止的恢复服务没有符合参与者的恢复目标，在这些背景下具有与物质使用相关的社会联系可能塑造注射启动援助。主题还突出了席克斯入学的个体级（即矛盾和与垫子相关的耻辱状物）和结构级（即成本和可用性）障碍。 Tijuana的禁欲的药物治疗和恢复服务被视为无法满足与会者的恢复相关目标，这可能限制了这些服务的潜在利益。需要修改药物处理和恢复服务，包括垫，以改善可接近的可达性和益处，例如防止过渡到药物注射中，用于PWID。
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