Background:
Many syringe service programs (SSPs) in the US are under-utilized by persons who inject drugs (PWID), and persons who use drugs but do not inject (PWUDNI) may perceive SSPs are not intended for their use. Harm reduction vending machines (HRVMs) containing safer injection products and other harm reduction products may be preferred over SSPs by some individuals, including PWUDNI, which could expand harm reduction’s overall reach. This study examines preference for HRVMs over SSPs across a typology encompassing injection behavior, distributive and/or receptive syringe sharing, and SSP utilization to consider possibilities for enhanced reach.
Methods:
Structured interviews were conducted with 712 PWUD in Perry and Rowan, Kentucky, USA. Participants rated acceptability of SSPs and HRVM; paired t-tests compared these two scales. HRVM preference was calculated by subtracting the SSP scale from the HRVM scale. With adjustments for demographics, types of drugs, and social determinants of health, linear regression compared HRVM preference across five groups based on past 6-month behaviors: (1) PWID with SSP use and distributive and/or receptive syringe sharing (reference group), (2) PWID with SSP use and no syringe sharing, (3) PWID with no SSP use and no syringe sharing, (4) PWID with no SSP use and syringe sharing, and (5) PWUDNI.
Results:
About 35.2% were PWID with no SSP use in the past 6 months. Participants rated HRVM acceptability (mean=4.49) significantly higher than SSPs (mean=4.17; t=-14.21, p<.001). Compared to the reference group, PWID with no SSP use and no syringe sharing (beta=.16, p<.01) and PWID with no SSP use and syringe sharing (beta=.24, p<.001) had greater preference for HRVM. PWUDNI also had greater preference for HRVM (beta=.31, p<.001).
Conclusion:
These differences in acceptability suggest HRVMs have potential to engage PWID not currently engaged in SSP services and PWUDNI, thus expanding access to harm reduction services. |