ID: HR23-469
Presenting author: Khine Wut Yee Kyaw

Presenting author biography:

I am a public health professional, working in the public health field for more than ten years. I have over five years of experience in operational research with proven research records, having thirty articles published in peer-review international journals. Research topics are around HIV, TB, harm reduction and SRHR.

The effect of different types of migration on symptoms of anxiety or depression and experience of violence among people who use or inject drugs in Kachin State, Myanmar

Khine Wut Yee Kyaw, Lucy Platt, Murdo Bijl, Sujit D Rathod, Aung Yu Naing, Bayard Roberts
Background
Evidence on mental health conditions and violence and their social determinants among people who inject or use drugs (PWID/UD) is limited, particularly in conflict-affected countries. Our aim was to estimate the prevalence of symptoms of anxiety or depression (outcome 1) and experience of emotional or physical violence in last 12 months (outcome 2) and their association with structural determinants, focusing on types of past migration (migration for any reason, economic or forced displacement).
Methodology
A cross-sectional survey was conducted among PWID/UD attending a harm reduction clinic between July and November 2021 in Waingmaw, Kachin State, Myanmar. Current symptoms of anxiety or depression were assessed using the Patient Health Questionnaire-4. Adjusted logistic regression models were used to measure associations between three types of past migration and the two outcomes.
Results
406, predominantly male (96.8%), PWID/UD were recruited. The median age (IQR) was 30 (25,37) years, most injected drugs (81.5%) and more commonly heroin or opium (85%). Symptoms of current anxiety or depression were high (32.8%), as was physical or emotional violence in the last 12 months (61.8%). Almost one-third (28.3%) had not lived in Waingmaw their whole life (migration for any reason), 77.9% had left home for work at some point (economic migration) and 19.5% had been forced to leave home due to armed conflict (forced displacement). Among the different types of migration, only forced displacement was associated with symptoms of anxiety or depression [aOR 2.33 (95% CI 1.32-4.11)] and recent experience of violence [aOR 2.18 (95% CI 1.15-4.15)].
Conclusion
Findings highlight the importance of integrating mental health services into existing harm reduction services to address high levels of anxiety or depression among PWID/UD, particularly those displaced by armed conflict. Findings also illustrate the imperative of reducing, and addressing the consequences of, violence experienced by PWID/UD.