Background:
Needle and Syringe Programmes (NSP) aims to reduce injecting-related harms among people who inject drugs (PWID). Some stakeholders have questioned the value of the City of Tshwane’s Community Oriented Substance Use Programme (COSUP) NSP services. Recent funding cuts have reduced the number of needles provided to PWID. We aimed to explore COSUP NSP clients’ experiences, perceived benefits and recommendations for NSP improvement.
Methods:
We employed a phenomenological approach and purposively sampled NSP clients from four COSUP sites across the city. Seven females and 24 males participated in four focus group discussions (FGDs). An open-ended FGD guide was administered to explore personal understanding and experience of using NSPs. FGDs were recorded, transcribed, coded, and thematically analysed in line with the Social Constructivism theoretical framework, making the participants’ narratives a rich source of socially constructed meanings.
Results:
Perceptions of the NSP were generally positive. Most participants believed that NSPs reduce HIV transmission risk and promote safer injecting. Participants reported that use of sterile injecting equipment and safe injecting education contributed to fewer complications of injecting, such as abscesses. Participants appreciated the safe space for reflection and change that NSPs provided. Some participants noted that NSPs reduced unsafe needle discarding through needle collection services. Several participants highlighted the value of the structured nature of the NSP; its educational benefits; and its role in facilitating access to opioid agonist therapy. However, participants highlighted that insufficient injecting equipment is provided; contributing to needle sharing and re-use. Participants also reported frequent inhumane treatment by law enforcement.
Conclusion:
NSPs in Tshwane provide several health benefits for PWID. Limited access to injecting equipment and hostile non-health actors hamper effectiveness. Efforts that will lead to the provision of sufficient injecting equipment and law enforcement support for NSPs could further enhance the public health benefits of NSPs in Tshwane. |