Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Subst Use Misuse. 2021;56(13):1933-1940. doi: 10.1080/10826084.2021.1958863. Epub 2021 Aug 6.
Syringe service programs (SSP) increasingly serve rural areas of the United States, yet little is known about access and perceived need for their services. : This paper presents the HIV and viral hepatitis prevention, testing, and treatment, and, substance use disorder treatment and overdose prevention services offered at three SSPs and which services their clients accessed. Across the three SSPs, 45 clients (people who inject drugs [PWID]), 11 staff, and five stakeholders were interviewed. : Most clients ( = 34) reported accessing SSP services weekly and primarily for sterile syringes and injection-related supplies. All clients reported testing for HIV at least once, though concern for acquiring or transmitting HIV was divided between some or no concern. Most clients ( = 43) reported testing for hepatitis C virus (HCV). Concern for acquiring or transmitting HCV was also mixed. Vaccination for hepatitis A and/or B teetered around half (HAV: = 23) to a third (HBV: = 15). Most clients ( = 43) knew where to access the overdose countering medication, Narcan. Feelings about substance use treatment options varied, yet most felt not enough were available. Of note, not all assessed services were offered by the sampled SSPs. : The findings help us understand PWIDs' rationale regarding services accessed and preference for particular services. The need for some services was not perceived by those at risk for the illness the services addressed. Discussing risk and providing tailored education is important when providing SSP services to rural residing PWIDs.
注射器服务项目（SSP）越来越多地为美国农村地区提供服务，但对于这些服务的可及性和需求感知知之甚少。本文介绍了三个 SSP 提供的 HIV 和病毒性肝炎预防、检测和治疗，以及物质使用障碍治疗和过量预防服务，以及他们的客户使用了哪些服务。在三个 SSP 中，对 45 名客户（注射毒品者[PWID]）、11 名工作人员和 5 名利益相关者进行了访谈。大多数客户（ = 34）报告每周至少使用一次 SSP 服务，主要是为了获得无菌注射器和与注射相关的用品。所有客户都报告至少进行了一次 HIV 检测，尽管对获得或传播 HIV 的担忧在一些人或无人之间存在分歧。大多数客户（ = 43）报告了丙型肝炎病毒（HCV）的检测。对获得或传播 HCV 的担忧也存在分歧。甲型和/或乙型肝炎疫苗接种率约为一半（HAV： = 23）至三分之一（HBV： = 15）。大多数客户（ = 43）知道在哪里可以获得纳洛酮等解毒药物。对物质使用治疗方案的选择各有不同，但大多数人认为选择有限。值得注意的是，并非所有评估的服务都由抽样 SSP 提供。研究结果有助于我们了解 PWID 对所获得服务的基本原理和对特定服务的偏好。对于那些面临所解决疾病风险的人来说，并非所有人都认为需要某些服务。在向农村居住的 PWID 提供 SSP 服务时，讨论风险和提供量身定制的教育非常重要。
