Abstract

Substance use continues to be a public health problem globally as it is associated with health issues, such lung or heart disease, stroke, cancer or mental health conditions. About 15% of South Africans uses substances and worsened during COVID-19 pandemic, with 0.02% being homeless. Substance use among homeless people is associated with sexually transmitted infections and a high level of morbidity and mortality, with the average life expectancy of homeless men living more than ten years on the street being 45-47 years old. Good health seeking behaviour is an important element of prevention, early diagnosis, and management of disease conditions, reducing cost, disability and death. This scoping review aimed to assess the healthcare seeking behaviors of homeless substance users during COVID-19 lockdowns. This review was conducted following PRISMA guidelines, where electronic databases such as consulting newspaper articles, credited website published reports and journals under Google Scholar. A total of 47 articles published in English between 2017 and 2022 were consulted, only using 27 for results synthesis. Results indicate difficult to access healthcare and only admission in hospitals as emergency cases. Factors associated with health seeking behaviors include lack of identification documents and address and stigma. Since many of studies addressing this topic were conducted in Europe and India, there is a need to explore healthcare seeking behaviors of homeless substance users during the COVID-19 lockdowns, in South Africa to inform strategies to improve healthcare utilization.