Abstract
BackgroundSubstance use contributes to poor health and increases the risk of mortality in the homeless population. This study assessed the prevalence and risk levels of substance use and associated factors among adults experiencing homelessness in Accra, Ghana.Methods305 adults currently experiencing sheltered and unsheltered homelessness in Accra aged ≥ 18 years were recruited. The World Health Organization’s (WHO) Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) was used to assess substance use risk levels. Association of high-risk substance use with sociodemographic, migration, homelessness, and health characteristics were assessed using logistic regression.ResultsNearly three-quarters (71%, n = 216) of the sample had ever used a substance, almost all of whom engaged in ASSIST-defined moderate-risk (55%) or high-risk (40%) use. Survivors of physical or emotional violence (AOR = 3.54; 95% confidence interval [CI] 1.89–6.65, p<.001) and sexual violence (AOR = 3.94; 95%CI 1.85–8.39, p<.001) had significantly higher odds of engaging in high-risk substance use, particularly alcohol, cocaine, and cannabis. The likelihood of engaging in high-risk substance use was higher for men than women (AOR = 4.09; 95%CI 2.06–8.12, p<.001) but lower for those in the middle-income group compared to low-income (AOR = 3.94; 95%CI 1.85–8.39, p<.001).ConclusionsRisky substance use was common among adults experiencing homelessness in Accra, and strongly associated with violent victimisation, gender, and income levels. The findings highlight the urgent need for effective and targeted preventive and health-risk reduction strategies to address risky substance use in the homeless population in Accra and similar cities within Ghana and sub-Sahara Africa with a high burden of homelessness.
Publisher
Public Library of Science (PLoS)
Reference107 articles.
1. Exploring the potential of technology-based mental health services for homeless youth: A qualitative study;EC Adkins;Psychol Serv,2017
2. Homeless individuals approaching the end of life: symptoms and attitudes;M Tobey;J Pain Symptom Manage,2017
3. Palliative care for homeless people: a systematic review of the concerns, care needs and preferences, and the barriers and facilitators for providing palliative care;HT Klop;BMC Palliat Care,2018
4. Conroy E, Burns L., Wilson S. Alcohol use disorder and cognitive impairment among older homeless persons. Foundation for Alcohol Research & Education. 2013. https://fare.org.au/alcohol-use-disorder-and-cognitive-impairment-among-older-homeless-persons-implications-for-service-delivery/
5. Substance use and access to health care and addiction treatment among homeless and vulnerably housed persons in three Canadian cities;A Palepu;PLoS One,2013
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献