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báo cáo khoa học: " Harm reduction, methadone maintenance treatment and the root causes of health and social inequities: An intersectional lens in the Canadian context"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Harm reduction, methadone maintenance treatment and the root causes of health and social inequities: An intersectional lens in the Canadian context | Smye et al. Harm Reduction Journal 2011 8 17 http www.harmreductionjournal.eom content 8 1 17 HARM REDUCTION JOURNAL RESEARCH Open Access Harm reduction methadone maintenance treatment and the root causes of health and social inequities An intersectional lens in the Canadian context Victoria Smye Annette J Browne Colleen Varcoe and Viviane Josewski Abstract Background Using our research findings we explore Harm Reduction and Methadone Maintenance Treatment MMT using an intersectional lens to provide a more complex understanding of Harm Reduction and MMT particularly how Harm Reduction and MMT are experienced differently by people dependent on how they are positioned. Using the lens of intersectionality we refine the notion of Harm Reduction by specifying the conditions in which both harm and benefit arise and how experiences of harm are continuous with wider experiences of domination and oppression Methods A qualitative design that uses ethnographic methods of in-depth individual and focus group interviews and naturalistic observation was conducted in a large city in Canada. Participants included Aboriginal clients accessing mainstream mental health and addictions care and primary health care settings and healthcare providers Results All client-participants had profound histories of abuse and violence most often connected to the legacy of colonialism e.g. residential schooling and ongoing colonial practices e.g. stigma everyday racism . Participants lived with co-occurring illness e.g. HIV AIDS Hepatitis C PTSD depression diabetes and substance use and most lived in poverty. Many participants expressed mistrust with the healthcare system due to everyday experiences both within and outside the system that further marginalize them. In this paper we focus on three intersecting issues that impact access to MMT stigma and prejudice social and structural constraints influencing enactment of peoples agency and homelessness Conclusions Harm reduction must move beyond a .