Characteristics and attendance patterns of a fixed-site NSP and nearby SVM: The benefits of 24-hour access to sterile injecting equipment

Cama, Elena; Brener, Loren; Bryant, Joanne

doi:10.3109/09687637.2014.956051

Cited by 12 publications

(19 citation statements)

References 24 publications

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“…In addition to SSPs, other public health strategies communities may consider implementing to ensure access to sterile injection equipment and minimize COVID-19 risks. For example, implementing public health vending machines, sometimes referred to as syringe vending machines, may hold promise for increasing access to harm reduction resources for populations underserved by the more traditional SSP model [ 22 , 23 ]. Mail-based supply distribution may also be of public health utility, particularly for meeting the needs of PWID residing in isolated areas with limited SSP access [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the impact of the COVID-19 pandemic on syringe services programs in rural Kentucky

Glick

Grieb²,

Harris

et al. 2022

Harm Reduct J

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Background The coronavirus pandemic (COVID-19) exacerbated risks for adverse health consequences among people who inject drugs by reducing access to sterile injection equipment, HIV testing, and syringe services programs (SSPs). Several decades of research demonstrate the public health benefits of SSP implementation; however, existing evidence primarily reflects studies conducted in metropolitan areas and before the COVID-19 pandemic. Objectives We aim to explore how the COVID-19 pandemic affected SSP operations in rural Kentucky counties. Methods In late 2020, we conducted eighteen in-depth, semi-structured interviews with persons (10 women, 8 men) involved in SSP implementation in rural Kentucky counties. The interview guide broadly explored the barriers and facilitators to SSP implementation in rural communities; participants were also asked to describe how COVID-19 affected SSP operations. Results Participants emphasized the need to continue providing SSP-related services throughout the pandemic. COVID-19 mitigation strategies (e.g., masking, social distancing, pre-packing sterile injection equipment) limited relationship building between staff and clients and, more broadly, the pandemic adversely affected overall program expansion, momentum building, and coalition building. However, participants offered multiple examples of innovative solutions to the myriad of obstacles the pandemic presented. Conclusion The COVID-19 pandemic impacted SSP operations throughout rural Kentucky. Despite challenges, participants reported that providing SSP services remained paramount. Diverse adaptative strategies were employed to ensure continuation of essential SSP services, demonstrating the commitment and ingenuity of program staff. Given that SSPs are essential for preventing adverse injection drug use-associated health consequences, further resources should be invested in SSP operations to ensure service delivery is not negatively affected by co-occurring crises.

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Section: Discussionmentioning

confidence: 99%

Exploring the impact of the COVID-19 pandemic on syringe services programs in rural Kentucky

Glick

Grieb²,

Harris

et al. 2022

Harm Reduct J

View full text Add to dashboard Cite

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“…To consider for a moment the relevance of this approach, however, we sometimes assume that NSPs deliver convenience, and that where there are gaps, vending machines could fill them. This is certainly part of the picture (Cama et al, 2014), but as this theory proposes (and as our interviews, discussed later, also suggest) convenience is more complicated than this. In addition, convenience, especially if narrowly defined, is not always the main priority for consumers.…”

Section: Approachmentioning

confidence: 99%

“…This could be seen as fundamentally a matter of coverage, which is undoubtedly a key issue for prevention (Cama et al, 2014). But convenience is more than this suggests.…”

Section: Conveniencementioning

confidence: 99%

Hepatitis C prevention and convenience: why do people who inject drugs in sexual partnerships ‘run out’ of sterile equipment?

Fraser

Rance

Treloar

2015

Critical Public Health

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Rates of hepatitis C virus transmission among people who inject drugs in Australia remain high despite decades of prevention education. A key site of transmission is the sharing of injecting equipment within sexual partnerships. Responsibility for avoiding transmission has long been understood individually, as have the measures designed to help individuals fulfil this responsibility, such as the distribution of sterile injecting equipment. This individualising tendency has been criticised for placing an unfair level of responsibility on poorly resourced, marginalised people, and ignoring the social nature of injecting drug use and related health care. Likewise, although research has demonstrated that injecting drug use is gendered, gender and sexual partnerships remain marginal to health promotion efforts. In this article we address these weaknesses, drawing on a qualitative, interview-based project that explored equipment sharing within (hetero)sexual partnerships. In conducting our analysis we explore a key theme that emerged in discussions about accessing and sharing injecting equipment, that of convenience, using critical marketing theory to understand this theme. In particular we investigate the issues of convenience that affect the use of sterile injecting equipment, the many factors that shape convenience itself, and the aspects of equipment use that go beyond convenience and into the realm of intimacy and meaning. We conclude that injecting equipment needs to be both meaningful and convenient if sharing within partnerships is to be reduced further. (Dwyer, Fraser, Treloar, 2011;Fraser, 2004). The packaging and distribution of 'fitpacks' to reduce injecting equipment sharing also tend to treat the target audience as a population of atomised gender-neutral individuals, each of whom should be supplied with individualised units of injecting equipment. In this article we ask, how can the socially embedded character of injecting within gendered sexual relationships be better acknowledged and accommodated in efforts to limit the spread of hepatitis C?One way to do this is to investigate equipment sharing via a research method that sees partnerships instead of individuals as the primary unit of analysis. This is the purpose of the project on which this article is based, an Australian National Health and Medical Councilfunded project entitled 'Understanding and prevention hepatitis C transmission in sexual partnerships'. In conducting our analysis we explore a key theme that emerged in 4 discussions about accessing and sharing injecting equipment in sexual partnerships, that of convenience, drawing on recent critical marketing theory to understand this theme. We begin with a background section, then follow this by detailing our approach and methods. In the analysis section that follows we explore the ways in which convenience affects the use of sterile injecting equipment, the many factors that shape convenience, and the issues the interviews illuminate that go beyond convenience and into the realm of in...

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“…Several studies have shown that some people who use ADMs differ from those who access face-to-face NSPs or pharmacies for injecting equipment, reporting that primary ADM users were younger, had shorter durations of injecting, injected less frequently, were less likely to report risky injecting practices or to have received opioid agonist treatment (OAT) [ 5 , 7 , 17 , 18 ]. However, two recent Australian studies suggested that when ADMs were located adjacent to face-to-face NSPs and near pharmacies, the ADM was primarily used by clients of face-to-face services who used the ADM outside business hours [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…In regard to HCV prevention and testing, some studies report that people who use ADMs report less syringe sharing [ 16 ] and do not differ from those who primarily use face-to-face NSPs in terms of HCV risk practices [ 8 , 20 , 21 ]. However, uptake of HCV testing and particularly treatment among people who use ADMs remains unclear, including potential gender differences.…”

Section: Introductionmentioning

confidence: 99%

Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study

Coupland

Henderson²,

Pritchard-Jones

et al. 2022

Harm Reduct J

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Background Global commitment to achieving hepatitis C virus (HCV) elimination has enhanced efforts in improving access to direct-acting antiviral (DAA) treatments for people who inject drugs (PWID). Scale-up of efforts to engage hard-to-reach groups of PWID in HCV testing and treatment is crucial to success. Automatic needle/syringe dispensing machines (ADMs) have been used internationally to distribute sterile injecting equipment. ADMs are a unique harm reduction service, affording maximum anonymity to service users. This paper explores the feasibility and acceptability of extending the HCV cascade of care to sites where ADMs are located. Methods The ADM users into Treatment (ADMiT) study was undertaken in a metropolitan region in Sydney, Australia. This mixed methods study involved analysis of closed-circuit television footage, ethnographic methods (fieldwork observation and in-depth interviews) and structured surveys. Researchers and peers conducted fieldwork and data collection over 10 weeks at one ADM site, including offering access to HCV testing and treatment. Results Findings from 10 weeks of fieldwork observations, 70 survey participants and 15 interviews highlighted that there is scope for engaging with this population at the time they use the ADM, and enhanced linkage to HCV testing and treatment may be warranted. Most survey participants reported prior HCV testing, 61% in the last 12 months and 38% had received HCV treatment. However, fieldwork revealed that most people observed using the ADM were not willing to engage with the researchers. Field work data and interviews suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. Discussion Enhanced linkage to HCV testing and treatment for people who use ADMs may be warranted. However, data suggested that extending the HCV cascade of care to ADMs may encroach on what is a private space for many PWID, utilized specifically to avoid engagement. The current study raises important public health questions about the need to ensure interventions reflect the needs of affected communities, including their right to remain anonymous.

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Characteristics and attendance patterns of a fixed-site NSP and nearby SVM: The benefits of 24-hour access to sterile injecting equipment

Cited by 12 publications

References 24 publications

Exploring the impact of the COVID-19 pandemic on syringe services programs in rural Kentucky

Exploring the impact of the COVID-19 pandemic on syringe services programs in rural Kentucky

Hepatitis C prevention and convenience: why do people who inject drugs in sexual partnerships ‘run out’ of sterile equipment?

Setting foot in private spaces: extending the hepatitis C cascade of care to automatic needle/syringe dispensing machines, a mixed methods study

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