Care Navigation Services: Experiences of People Who Inject Drugs
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.