Abstract

Background

Syringe service programs (SSP) increasingly serve rural areas of the United States, yet little is known about access and perceived need for their services. Objectives: 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. Results: Most clients (n = 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 (n = 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: n = 23) to a third (HBV: n = 15). Most clients (n = 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. Conclusions/Importance: 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.

中文翻译：

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获得艾滋病毒、病毒性肝炎和药物滥用治疗/过量预防服务：对农村注射吸毒者服务的注射器服务计划 (SSP) 的定性分析

摘要

背景

注射器服务计划 (SSP) 越来越多地为美国农村地区提供服务，但人们对其服务的获取和感知需求知之甚少。目标：本文介绍了三个 SSP 提供的艾滋病毒和病毒性肝炎预防、检测和治疗，以及物质使用障碍治疗和过量预防服务以及其客户获​​得的服务。在三个 SSP 中，采访了 45 名客户（注射毒品者 [PWID]）、11 名工作人员和 5 名利益相关者。结果：大多数客户 ( n  = 34) 报告每周都会访问 SSP 服务，主要是为了无菌注射器和注射相关用品。所有客户都报告至少接受过一次艾滋病毒检测，但对感染或传播艾滋病毒的担忧分为有担忧和无担忧两种。大多数客户 ( n  = 43) 报告进行了丙型肝炎病毒 (HCV) 检测。对感染或传播丙型肝炎病毒的担忧也参差不齐。甲型和/或乙型肝炎疫苗接种率徘徊在一半（HAV：n  = 23）到三分之一（HBV：n  = 15）之间。大多数客户 ( n  = 43) 知道在哪里可以获得药物过量药物纳洛酮 (Narcan)。对药物滥用治疗方案的看法各不相同，但大多数人认为可用的治疗方案不够。值得注意的是，并非所有评估的服务都是由抽样的 SSP 提供的。结论/重要性：研究结果有助于我们了解注射吸毒者获取服务的理由以及对特定服务的偏好。那些面临服务所针对疾病风险的人并未意识到对某些服务的需求。在向农村吸毒者提供 SSP 服务时，讨论风险和提供量身定制的教育非常重要。