‘The biggest mistake God ever made was to create junkies’: Unsafe injection practices, health care discrimination and overdose deaths in Montreal, Canada
Bibliographic record
Abstract
Despite the existence of prevention programmes in Montreal, Canada, injection drug users (IDUs) continue to share their injection drug equipment. This practice has led to an increase in the incidences of HIV and Hepatitis C (HCV) among IDUs since 2003. The present study was conducted to explore factors contributing to the increased risks of this morbidity. Semi-structured qualitative interviews were conducted as drug users were actively involved in their routine activities. The participants’ narratives indicate that IDUs in Montreal are involved in risky injection behaviour that increases HIV, HCV and bacterial transmission. Moreover, IDUs in Montreal are at an increased risk of overdose and death when they are forced to inject in public washrooms or alleys. In addition, many IDUs have placed the general public at risk by discarding their used needles in public parks, sidewalks and public washrooms. Furthermore, many IDUs in Montreal have faced discrimination and are refused treatment by the health care system. Micro- environmental factors, such as a paucity of safe injection sites, inaccessibility of injection equipment and discrimination all seem to be contributing factors in recent increases in HIV and HCV in Montreal.Malgré les programmes de prévention qui existent à Montréal, Canada, les utilisateurs de drogues injectables (UDI) continuent de partager leurs seringues. Cette pratique a mené à une augmentation de l’incidence du virus de l’immunodéficience humaine (VIH) et du virus de l’hépatite C (VHC) parmi les UDI depuis 2003. La présente étude a été menée afin d’examiner les facteurs qui contribuent à l’augmentation des risques de cette morbidité. Des entretiens qualitatifs semi-directifs ont été réalisés pendant que les utilisateurs faisaient usage de drogues. Les commentaires recueillis auprès des participants ont confirmé que les UDI de Montréal adoptent des comportements d’injection qui augmentent les risques de contracter le VIH et le VHC en plus de faciliter la transmission de bactéries. De plus, le risque de surdose et de mort est plus élevé chez les UDI de Montréal lorsqu’ils sont forcés de s’injecter des drogues dans des toilettes publiques ou dans des ruelles. En outre, de nombreux UDI compromettent la sécurité du public en jetant leurs seringues dans les parcs publics, sur les trottoirs ou dans les toilettes publiques. Par ailleurs, de nombreux UDI de Montréal ont été victimes de discrimination et se sont vus refuser l’accès à des traitements par le système de santé publique. Des facteurs micro-environnementaux, tels que la rareté de sites d’injection supervisés, l’inaccessibilité aux seringues et la discrimination, s’avèrent tous des facteurs qui semblent contribuer à l’augmentation récente de l’incidence du VIH et du VHC à Montréal.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".