Services de navigation des soins : expériences des personnes s’injectant des drogues

Ntizobakundira, Monge; Fortin, Laurence; Monson, Eva; Arruda, Nelson; Bruneau, Julie; Loignon, Christine

doi:https://doi.org/10.7202/1106256ar

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Résumé

Contexte. Les personnes utilisatrices des drogues injectables (PUDI) vivent de la stigmatisation, de la discrimination, un faible soutien et des interactions difficiles avec les professionnels dans le système de soins. Cela entraîne un accès limité aux soins, notamment la prophylaxie préexposition (PrEP) contre le virus de l’immunodéficience humaine (VIH) et les nouveaux traitements d’hépatite C (HC). Les services de navigation peuvent améliorer l’accès à ces soins. Cette analyse documentaire vise à synthétiser les connaissances disponibles sur les expériences des PUDI avec les services de navigation liés à la PrEP et aux soins de l’HC.

Méthodes. Une recherche documentaire a été menée à partir de cinq bases de données et complétée par la vérification des listes de références et une recherche manuelle de la littérature grise. Les données pertinentes ont été extraites et synthétisées selon l’approche narrative. Un total de quatorze articles ont été inclus dans cette analyse documentaire.

Résultats. Les services de navigation analysés dans cette synthèse sont la colocation des soins dans les sites fixes ou mobiles, la référence externe à l’aide des intervenants et le soutien des pairs. Les bénéfices de ces services pour les PUDI ressortent de manière unanime. La colocalisation des soins semble la plus optimale grâce à la facilité, la rapidité d’accès aux soins ainsi que l’environnement familier et non stigmatisant pour les PUDI. La confiance établie avec les professionnels ainsi que l’importance des pairs ont aussi été relevées. Cependant, les difficultés antérieures dans le système de soins standard persistent.

Discussion. La colocalisation des soins dans les lieux non stigmatisants et une bonne relation de confiance avec les professionnels sont centrales pour l’expérience de navigation des PUDI liée à la PrEP et aux soins d’HC. D’autres études sont nécessaires pour approfondir les facteurs personnels et contextuels liés à l’expérience de navigation des PUDI.

Mots-clés :

personnes utilisatrices de drogues injectables,
services de navigation,
prophylaxie pré-exposition,
soins de l’hépatite C,
expériences

Abstract

Context. People who use injection drugs (PWID) experience stigma, discrimination, lack of support, and difficult interactions with professionals in the care system. This results in limited access to needed care, including pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) and new hepatitis C (HC) treatments. Navigation services can improve access to such care among PWID. Thus, this review aims to synthesize the available knowledge on PWID’s experiences with PrEP and HC care-related navigation services.

Methods. A literature search was conducted using five databases, supplemented by checking reference lists and a manual search of the grey literature. Relevant data were extracted and synthesized using the narrative approach. A total of fourteen articles were included in this review.

Results. The navigation services analyzed in this synthesis are co-location of care in fixed or mobile sites, external referral with intervener assistance and peer support. The benefits of these services for PWID are unanimous.

Co-location of care seems to be the most optimal because of the ease and timeliness of access to care as well as the familiar and non-stigmatizing environment for the majority of PWID. Good trust with professionals and the importance of peers for PWID were also reported. However, previous difficulties in the standard care system remain.

Discussion. Co-location of care in non-stigmatizing settings and a good, trusting relationship with professionals is preferred by PWID in their navigation related to PrEP and HC care. But more studies are needed to further explore personal and contextual factors in PWID experience with navigation.

Keywords:

PWID,
navigation services,
PrEP,
HVC health care,
experiences

Resumen

Contexto: Los usuarios de drogas inyectables experimentan estigmatización, discriminación, un apoyo débil e interacciones difíciles con los profesionales del sistema de salud. Esto significa que tienen un acceso limitado a la atención, principalmente en lo que respecta a la profilaxis preexposición contra el virus de la inmunodeficiencia humana (VIH) y los nuevos tratamientos para la hepatitis C. Los servicios de navegación pueden mejorar el acceso a estos cuidados, por lo que esta revisión apunta a sintetizar los conocimientos disponibles sobre las experiencias de quienes usan drogas inyectables con los servicios de navegación relacionados con la profilaxis preexposición y la atención de la hepatitis C.

Método: Se llevó a cabo una investigación documental a partir de cinco bases de datos, completada por la verificación de listas de referencia y una investigación manual de la literatura gris. Los datos pertinentes fueron extraídos y sintetizados siguiendo un enfoque narrativo. Un total de 14 artículos fueron incluidos en esta revisión.

Resultados: En esta síntesis se han analizado los servicios de navegación colocalizados en sitios fijos o móviles, la referencia externa por medio de agentes de intervención y el apoyo de los pares. Los beneficios de estos servicios para los usuarios de drogas inyectables se destacan de manera unánime. La colocalización de los cuidados parece ser óptima merced a la facilidad y la rapidez de acceso a la atención y al ambiente familiar y no estigmatizante que ofrecen a los usuarios de drogas inyectables. La confianza que se establece con los profesionales y la importancia de los pares ha sido también destacada. Sin embargo, persisten las dificultades anteriores que presenta el sistema de atención estándar.

Discusión: La colocalización de la atención en sitios no estigmatizantes y una buena relación de confianza con los profesionales son centrales para la experiencia de navegación de quienes se inyectan drogas con respecto a la profilaxis preexposición y a la atención de la hepatitis C. Es necesario llevar a cabo otros estudios para profundizar los factores personales y contextuales vinculados con la experiencia de navegación realizada por las personas que utilizan drogas inyectables.

Palabras clave:

personas que utilizan drogas inyectables,
servicios de navegación,
profilaxis preexposición,
atención de la hepatitis C,
experiencias

Parties annexes

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Services de navigation des soins : expériences des personnes s’injectant des droguesCare Navigation Services: Experiences of People Who Inject DrugsServicios de navegación en el sistema de atención de la salud: experiencias de personas que se inyectan drogas[Notice]

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