Author: Rojas S, Asmus L, Connolly K, Ransom S, Ramers C

Theme: Epidemiology & Public Health Research Year: 2019

Background: Syringe Service Programs (SSPs) an evidence-based harm reduction intervention known to
reduce the risk of HIV, Hepatitis B (HBV) and Hepatitis C (HCV), yet comprehensive client data is limited.
Since 2002, SafePoint San Diego, an SSP operating at two locations at three sessions weekly, has
provided syringe exchange, HIV/HCV testing, naloxone distribution, referrals to primary care, mental
health and substance abuse treatment.
Methods: On initial visit, clients complete a 37-question survey covering basic demographic information,
drug use habits, infectious disease risk, and overdose experience. Since 2014, we collected data from
4,174 new clients. A subset of these clients, underwent HCV testing after 2014.
Results: Most SafePoint clients were white (67%), unemployed (71%) males (73%), age 30-50 (48%).
Many reported at least some college (46%), however most had extremely low income (86%) and many
were homeless (63%). 40% reported using more than one substance and 18% reported combining
substances; 42% had used someone else’s needles/works in the last 12 months. At intake, most clients
reported knowing HIV/HCV status of injecting partners (66%, 65% respectively) and 93% and 79%
reported screening for HIV/HCV, with 25% HCV-infected and 6% HIV-infected. Opt-in HCV testing offered
periodically demonstrated 50% HCV antibody positivity (n=115). Of those with an RNA level drawn, 81%
were chronically infected (n=26). 76% reported an HCV evaluation and 82% reported being in care. 35%
reported a personal overdose history and almost double that had witnessed an overdose.
Conclusions: SSP survey data underscore complicated polysubstance abuse, and high medical needs.
Experience with overdose, either personal or witnessed, was high. Many reported being unaware of the
HIV and HCV status of injecting partners, and the HCV infection rate, based on a subset of clients, was
high. This study provides rich pilot data for planning future health and harm reduction interventions in
this population.
Dr Ramers has received honoraria Gilead Sciences, AbbVie, Inc, and Merck, consulting fees from
Gilead Sciences and AbbVie, and research support from Gilead Sciences. No pharmaceutical
grants were received in the development of this study

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