Merchants, samaritans, and public health workers: Secondary syringe exchanger discursive practices

Abstract

SSEs hold heterogeneous motivations and operate in multiple contexts. Many SSEs see themselves as, and behave as, informal health care workers or helpers in their community. They could be utilized, with minimal training and encouragement, to disseminate additional harm reduction information and materials.

Decreased Odds of Injection Risk Behavior Associated With Direct Versus Indirect Use of Syringe Exchange: Evidence From Two California Cities

“…Secondary exchange occurs most frequently within established injecting networks comprised of close friends, sexual partners and family members (Brothers, 2016; Bryant and Hopwood, 2009; Craine et al, 2010; De et al, 2008; Fisher et al, 2013; Green et al, 2010; Huo et al, 2005; Lenton et al, 2006; Lorvick et al, 2006; Marshall et al, 2015; Murphy et al, 2004; Newland et al, 2016; Snead et al, 2003; Tyndall et al, 2002) but it may also involve PWID who acquire large numbers of syringes to sell or distribute outside their personal networks often at some distance from a fixed-site SEP (Lenton et al, 2006; Newland et al, 2016; Valente et al, 1998; Valente et al, 2001). In Baltimore, for example, it was estimated such high-volume “satellite” exchangers, representing less than 10% of SEP clients, accounted for nearly 65% of syringes distributed (Valente et al 1998).…”

“…This may be particularly important for women and younger and more recent-onset drug users who are much less likely to attend an SEP (Anderson et al, 2003; Craine et al, 2009; Murphy et al, 2004; Riehman et al 2004). Secondary syringe exchange also benefits PWID in ways that go well beyond increasing access to sterile syringes, as secondary exchangers often serve a health care or “doctoring” function by providing PWID with information about safer injecting practices, drug overdose prevention, vein care and referrals to HIV and HCV testing and drug abuse treatment as well as resources for acquiring ancillary injection equipment such as drug cookers and filters, sterile water and swabs (Anderson, 2003; Brothers, 2016; Dechman, 2015; Fisher et al, 2013; Marshall et al, 2015; Newland et al, 2016; Snead et al, 2003). …”

Addressing the problem of sterile drug injecting supply acquisition for people who inject drugs.

“…This model is the intermediary between a strict one-for-one policy and a needs-based model (Bluthenthal et al, 2007). SEPs using a needs-based approach may serve as an important aspect in increasing SEP reach through secondary exchange (Brothers, 2016). The Centers for Disease Control (CDC) recommends a sterile syringe be used for each injection, and a needs-based model of syringe exchange ensures PWID have a sterile syringe for each injection (2019).…”

“…Secondary exchange is common across the United States and serves as an opportunity for SEP harm reduction principles to reach PWID who might not directly engage in SEP services (Behrends et al, 2017). Brothers (2016) suggests there are a number of reasons PWID may not visit SEP, including distance, operating hours, disability, fear of police, fear of being identified, and feelings such as shame, anxiety, and stigma. PWID attending SEP who provide sterile supplies to other PWID serve important role in sterile supply access solutions (Behrends et al, 2017;Brothers, 2016).…”

“…Brothers (2016) suggests there are a number of reasons PWID may not visit SEP, including distance, operating hours, disability, fear of police, fear of being identified, and feelings such as shame, anxiety, and stigma. PWID attending SEP who provide sterile supplies to other PWID serve important role in sterile supply access solutions (Behrends et al, 2017;Brothers, 2016). The SEP participants providing secondary exchange are often friends, family members, or intimate partners of those receiving supplies as part of secondary exchange (Behrends et al, 2017).…”