Journal Article

Injections and infections: understanding syringe service program utilization in a rural state

Burris, Debra, Thakarar, Kinna, Lucas, Frances L., Sankar, Nitysari, Murray, Kimberly, Smith, Robert P.

2021

Overview

Background Increasing rates of injection drug use (IDU) associated-infections suggest significant syringe service program (SSP) underutilization. Our study objective was to assess practices of safe injection techniques and to determine predictors of SSP utilization in a rural state. Patients and methods This was a fifteen-month cross-sectional study of participants hospitalized with IDU-associated infections in Maine. Data were collected through Audio Computer-Assisted Self-Interview survey and medical record review. Descriptive analyses were performed to characterize demographics, health characteristics, and injection practices. The primary outcome was SSP utilization, and the main independent variable was self-reported distance to SSP. Logistic regression analyses were performed to identify factors associated SSP utilization, controlling for gender, homelessness, history of overdose, having a primary care physician and distance to SSP. Results Of the 101 study participants, 65 participants (64%) reported past 3 month SSP utilization, though only 33% used SSPs frequently. Many participants (57%) lived more than 10 miles from an SSP. Participants who lived less than 10 miles of an SSP were more likely to use an SSP (adjusted odds ratio 5.4; 95% CI 1.9–15.7). Conclusions Our study highlights unsafe injection practices and lack of frequent SSP utilization among people admitted with IDU-associated infections in a rural state. Especially given increasing stimulant use, these results also highlight the need for SSP access. Particularly in rural areas where patients may live more than 10 miles from an SSP, expansion of harm reduction services, including mobile units, should be a priority.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Audio data / Cocaine / COVID-19 / Cross-Sectional Studies / Demographics / Demography / Disease prevention / Drug use / Electronic health records / Endocarditis / Forecasts and trends / Gender / Harm Reduction / Health aspects / Health care / Health Promotion and Disease Prevention / Health Psychology / Hepatitis B / Hepatitis C / HIV / Homelessness / Human immunodeficiency virus / Humans / Hypodermic needles / Hypodermic syringes / Immunization / Independent variables / Infections / Infectious diseases / Injection / Injection drug use (IDU) / Injections and infections / Intravenous drug abuse / Medicine / Medicine & Public Health / Methods / Narcotics / Needle-Exchange Programs / Overdose / Patients / Rural areas / Rural State / Safety and security measures / Social Policy / Social Work / Substance Abuse, Intravenous - epidemiology / Syringe Service / Syringe service program (SSP) / Syringes / Utilization / Variables