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How has COVID-19 impacted access to STBBI-related health services, including harm reduction services, for people who use drugs or alcohol in Canada? Published: ()
The COVID-19 pandemic has changed how people who use drugs or alcohol in Canada access healthcare services. To better understand how the COVID-19 pandemic has affected access to sexually transmitted and blood-borne infection (STBBI) prevention, testing and treatment services, and harm reduction services, for people who use drugs or alcohol, the Public Health Agency of Canada (PHAC) conducted an anonymous online survey in January and February 2021. The survey included anyone 18 years or older who was living in Canada and who identified as a person who used drugs, alcohol or cannabis in the past 6 months. In total, 1034 people from across Canada participated.
1034 participants
1/2
Just over half were under the age of 40
8 in 10
85% self-identified as White
Less than 1 in 10 self-identified as:
- First Nations, Métis or Inuit (9%) or
- Black (3%) or
- South Asian (3%)
7 in 10
70% were living with family at the time of survey
1 in 5
20% were living alone at the time of survey
1 in 10
9% were living in precarious or inadequate housing
Mental health and wellness
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24% reported their mental health was excellent or very good at the time of survey
<2/10
16% reported their mental health was poor at the time of the survey
6/10
60% reported their mental health status was worse since the start of the COVID-19 pandemic
2/3
66% of those who tried to access mental health services were not always able to access these services
Financial and food security
1/3
32% reported reduced hours and/or pay, or had to stop working since the start of the COVID-19 pandemic
1/3
36% reported a major or moderate impact of the COVID-19 pandemic on the ability to pay bills
4/10
42% experienced food insecurity since the start of the COVID-19 pandemic
Drug and alcohol use and their increased use since the start of the COVID-19 pandemic
9/10
89% reported using alcohol, of whom 57% increased use of alcohol
2/3
68% reported using cannabis, of whom 61% increased use of cannabis
<2/10
- 19% reported using cocaine or crack, of whom 45% increased use of cocaine or crack
- 15% reported using speed, methamphetamine, or crystal meth, of whom 52% increased use of these drugs
- 13% reported using opioids, of whom 57% increased use of opioids
Impact of COVID-19 on access to STBBI-related services
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50% of those living with HIV experienced challenges accessing a HIV care provider or clinic since the start of the COVID-19 pandemic
Participants reported difficulties accessing STBBI-related services:
- HIV testing: 50% were not always able to access
- Hepatitis C testing: 48% were not always able to access
- Other sexually transmitted infection testing: 57% were not always able to access
- Needle and syringe distribution programs: 58% were not always able to access
- Drop-in centres for people who use drugs: 84% were not always able to access
- Drug checking services: 83% were not always able to access
- Naloxone training: 50% were not always able to access
Top reasons why people were not able to access STBBI-related services:
- Reduced hours of operation or the service was closed
- Difficulty getting an appointment
- Difficulty accessing the service because of COVID-19 related public health measures
- Fear of, concern about or experienced stigma, discrimination, or violence
Acknowledgements
This data blog update and the success of the survey would not be possible without the collaboration of the Canadian Association of People who Use Drugs (CAPUD)-led national expert working group. The expert working group was comprised of people with lived and/or living experience of drug use, individuals from the African, Caribbean, Black (ACB), Indigenous and 2SLGBTQIA+ communities, from community-based organizations offering STBBI-related services, academic institutions and advocacy groups. The authors thank Natasha Touesnard and Matthew Bonn for their review of the findings. The authors gratefully acknowledge the contribution of the participants.
Suggested citation
Survey of the impact of COVID-19 on access to STBBI-related health services including harm reduction services among people who use drugs or alcohol in Canada. Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control. 2021.