Department of Health Sciences, College of Health Professions and Sciences, University of Central Florida, Orlando, FL, USA.
Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA.
Harm Reduct J. 2024 Nov 14;21(1):198. doi: 10.1186/s12954-024-01116-5.
People who use drugs are at elevated sexual and reproductive health risk but experience barriers to services. Syringe services programs (SSP) are an important venue to provide integrated health services. Few studies have examined SSP use within intersecting gender, racial, and ethnic groups, including by injection drug use (IDU), and differences in sexual and reproductive health among these groups.
Within a cohort study among people who use unprescribed opioids in New York City, we conducted a nested cross-sectional study from November 2021-August 2022 assessing sexual health with a survey (n = 120). The parent study measured baseline characteristics, and the cross-sectional study survey measured self-reported past-year SSP use and sexual and reproductive health. We estimated SSP use within gender, racial, and ethnic groups by IDU, and the prevalence of sexual and reproductive health outcomes by gender, race, ethnicity, and SSP use.
Among men (n = 61) and women (n = 54), SSP use was disproportionately low among Black participants irrespective of IDU. Women reporting SSP use had a higher prevalence of multiple, new, sex trade, and/or casual sex partners, history of STI symptoms, and lack of effective STI prevention, although women who did not use SSP had non-negligible levels of risk with variation between racial and ethnic groups. Among men, sexual and reproductive health varied across racial and ethnic groups but not as clearly by SSP use.
SSP offer opportunity to address elevated STI risk among people who use drugs but may miss certain intersecting gender, race, and ethnic groups.
使用毒品的人存在较高的性健康和生殖健康风险，但他们在获得服务方面面临障碍。注射毒品者安全套服务项目（SSP）是提供综合健康服务的重要场所。很少有研究检查过 SSP 在交叉性别、种族和族裔群体中的使用情况，包括注射吸毒者（IDU），以及这些群体之间性健康和生殖健康的差异。
在纽约市使用未处方类阿片药物的人群队列研究中，我们开展了一项嵌套横断面研究，于 2021 年 11 月至 2022 年 8 月使用调查评估性健康（n=120）。母研究测量了基线特征，而横断面研究调查测量了自我报告的过去一年 SSP 使用情况以及性健康和生殖健康情况。我们根据 IDU 估计了性别、种族和族裔群体中的 SSP 使用情况，以及根据性别、种族、族裔和 SSP 使用情况评估了性健康和生殖健康结局的流行率。
在男性（n=61）和女性（n=54）中，无论 IDU 情况如何，黑人参与者的 SSP 使用比例都不成比例地低。报告使用 SSP 的女性具有更多的多个、新的、性交易和/或随意性伴侣、性传播感染症状史和缺乏有效的性传播感染预防措施的较高流行率，尽管未使用 SSP 的女性也存在不可忽视的风险，且风险在不同种族和族裔群体之间存在差异。在男性中，性健康和生殖健康在种族和族裔群体之间存在差异，但 SSP 使用情况并没有那么明显。
SSP 为解决吸毒者中较高的性传播感染风险提供了机会，但可能会错过某些交叉性别、种族和族裔群体。
