Impact of COVID-19 on the delivery of STBBI-related services in Canada, including harm reduction services, for people who use drugs or alcohol

Findings from the Survey of the impact of COVID-19 on access to sexually transmitted and blood borne infection (STBBI)-related health services, including harm reduction services, for people who use drugs or alcohol in Canada.

The Public Health Agency of Canada, in a collaboration with community stakeholders, conducted an online survey from January to February 2021.

• Territories: 1%
• British Columbia: 17%
• Alberta: 7%
• Saskatchewan: 4%
• Manitoba: 5%
• Ontario: 40%
• Quebec: 12%
• Atlantic: 17%

Who participated

1,034 people who used drugs or alcohol in the 6 months prior to the survey:

• 53% were under the age of 40
• 85% white
• 61% cisgender female
• 85% have more than high school education
• 5% reported currently living with HIV
• 6% reported ever been told to have hepatitis C infection

Since the start of the COVID-19 pandemic

• Mental health: 60% felt their mental health was worse
• Food security: 42% experienced food insecurity
• Financial security: 56% reported a major or moderate impact on ability to pay bills

Substance use since the start of the COVID-19 pandemic

Among participants who used only alcohol and/or cannabis (n=451)

• 57% reported an increased use of cannabis
• 56% reported an increased use of alcohol

Among participants who used illegal drugs (n=845)

• Reported changed in use of illegal drugs:
• 57% increased use of heroin, fentanyl or other non-medical opioids
• 45% increased used of cocaine or crack
• Reported changes in substance use behaviours:
• 75% increase of different triggers for using
• 66% increase in using alone

Accessed, considered accessing or wanted to access

26% STBBI-related services

Experienced difficulty accessing:

• HIV, hepatitis C and other sexually transmitted infection (STI) testing
• pre-exposure prophylaxis (PrEP) and/or post-exposure prophylaxis (PEP)
• mental health counselling referral

39% harm reduction services

Experienced difficulty accessing:

• needle and syringe distribution programs
• drug checking services
• drug consumption rooms

30% substance use and treatment services

Experienced difficulty accessing:

• drug treatment in therapeutic communities
• drug treatment in outpatient mental health care centres
• drug treatment in psychiatric hospitals

Among all participants

Reasons why participants were not able to access STBBI, harm reduction, substance use and treatment services:

• Reduced hours or service closure
• Difficulty getting appointment or referral
• Difficulty contacting doctor or nurse
• COVID-19 public health measures
• Fear of, concern about or experienced stigma, discrimination, violence
• Fear of, concern about COVID-19 exposure

Acknowledgements

The authors gratefully acknowledge the valuable input and contribution of the survey participants. For more information, look for the Data Blog and the full-length report titled National Report: Findings from the Survey of the impact of COVID-19 on access to STBBI-related health services including harm reduction services for people who use drugs or alcohol in Canada.