학술논문
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.
Document Type
Academic Journal
Author
Chayama KL; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada.; Interdisciplinary Studies Graduate Program, University of British Columbia, 6371 Crescent Road, Vancouver, Canada.; Ng C; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada.; Fleming T; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada.; Interdisciplinary Studies Graduate Program, University of British Columbia, 6371 Crescent Road, Vancouver, Canada.; Small W; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada.; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, Canada.; Sue KL; Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, 06520, USA.; Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, USA.; McNeil R; British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, Canada. ryan.mcneil@yale.edu.; Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, 06520, USA. ryan.mcneil@yale.edu.; Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, USA. ryan.mcneil@yale.edu.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101153624 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7517 (Electronic) Linking ISSN: 14777517 NLM ISO Abbreviation: Harm Reduct J Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Housing 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.
Methods: Between 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.
Results: Many 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.
Conclusion: The 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.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Methods: Between 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.
Results: Many 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.
Conclusion: The 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.
(© 2023. BioMed Central Ltd., part of Springer Nature.)