Housing-based syringe services programs to improve access to safer injecting equipment for people who inject drugs in Vancouver, Canada: a spatially oriented qualitative study

Harm Reduction Journal

Research

Cara Ng¹  Will Small²  Koharu Loulou Chayama³  Taylor Fleming³  Ryan McNeil⁴  Kimberly L. Sue⁵ 

[1] British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada;British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada;Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, Canada;British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada;Interdisciplinary Studies Graduate Program, University of British Columbia, 6371 Crescent Road, Vancouver, Canada;British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada;Program in Addiction Medicine, Yale School of Medicine, 06520, New Haven, CT, USA;Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, USA;Program in Addiction Medicine, Yale School of Medicine, 06520, New Haven, CT, USA;Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, USA;

关键词: Housing;    Injection drug use;    People who inject drugs;    Syringe services programs;   

DOI  :  10.1186/s12954-023-00862-2

 received in 2023-04-19, accepted in 2023-08-27,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundHousing environments shape injection drug-related risks and harms and thus represent a critical implementation setting for syringe services programs (SSPs). As critical harm reduction measures, SSPs provide safe injecting equipment to people who inject drugs (PWID). Vancouver, Canada, has well-established syringe distribution programs through which PWID have low-threshold access to unlimited syringes and related injecting equipment, including through non-profit operated supportive housing and single-room occupancy hotels. This study examines the role of housing-based SSPs in distributing injecting equipment to PWID in Vancouver.MethodsBetween January and March 2020, semi-structured, in-depth interviews were conducted in Vancouver with 26 PWID. Interviews were audio-recorded, transcribed, and coded. Salient themes were identified using inductive and deductive approaches.ResultsMany participants accessed SSPs in housing facilities and expressed preference for these programs over those offered at other locations and through other health and social services. Three major themes emerged to explain this preference. First, most participants injected in the buildings where they resided, and housing-based SSPs made injecting equipment available when and where it was most needed. Second, many participants preferred to avoid carrying syringes outside of the places where they inject due to fears that syringe possession may lead to criminal charges or confiscation of syringes and/or illicit drugs by police. Third, for some participants, anti-drug user stigma and concerns over unwillingly disclosing their drug use hindered access to SSPs outside of housing settings. Programs operated within housing facilities often offered greater client anonymity along with more supportive and less stigmatizing environments, particularly in the presence of peer staff.ConclusionThe current study advances understanding of access to injecting equipment in a setting with city-wide syringe distribution programs. Our findings underscore the benefits of housing-based SSPs and encourage the expansion of such services to maximize access to harm reduction supports for PWID.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 3