Theme: Clinical Research Year: 2019
Background: Syringe exchange programs (SEPs) serve populations with high rates of unmet
health needs, and completion rates of offsite health care referrals are low. We describe a novel
partnership between an academic medical center and an SEP to deliver low barrier healthcare
to people who inject drugs (PWID) onsite at an SEP.
Methods: A collaboration between Montefiore Medical center and a local SEP, a clinic was
opened at an SEP drop-in center on February, 11, 2019. We conducted a retrospective chart
review of patients seen at the clinic from 2/11/2019-5/29/2019 using the electronic medical
record.
Results: A total of 118 patients were seen by a provider during the study period. The mean age
was 43 (IQR 17). The majority of patients were Hispanic (44%), followed by non-Hispanic Black
(32%) and were female (53%). The primary reason for a patient’s first visit to the clinic was for
buprenorphine treatment (32%), followed by hepatitis C treatment (20%) and PREP (20%). Of
those who initiated buprenorphine treatment, 72% were retained in treatment at 30 days. Of
the patients with HCV, 40% were currently injecting drugs; 40% were using heroin, and 30%
were using cocaine/crack. All HCV+ patients received an appropriate HCV evaluation with
fibrosis determination. Most are awaiting insurance approval for medication, however 15%
have initiated treatment. 30% of patients evaluated for HCV treatment also initiated
buprenorphine.
Conclusion: Through a novel SEP-academic medical center partnership, PWID received
buprenorphine, HCV, and HIV prevention services on-site at an SEP, demonstrating the
feasibility of such initiatives. Rates of retention in buprenorphine treatment are comparable to
retention rates at non-SEP office-based treatment programs, and many people received both
HCV treatment, as well as buprenorphine treatment. Low barrier care delivered onsite at an
SEP should be further explored to improve access to care for PWID.
Disclosure of Interest: none