Theme: Epidemiology & Public Health Research Year: 2024
Background: In the United States (US), people who use drugs have low engagement with primary care services and high utilization of emergency medical services. Syringe services programs (SSPs) may be better venues for engaging people who use drugs (PWUD) in healthcare since they provide low stigma environments for care. This qualitative study offers insight on how SSPs organizationally deliver health services in the US.
Methods: We purposely recruited a nationally representative sample of SSPs from respondents of a national survey who reported that their SSP offered health services. We interviewed SSP program directors from February to August 2023 on video calls using a semi-structured interview guide that asked about the type of services provided and how they were delivered. We recruited until saturation (N= 23 SSPs). We conducted content analysis to identify themes that describe organizational delivery of health services at SSPs nationally.
Results: We identified three major themes related to health service delivery by SSPs in the US: 1) SSPs may utilize partnerships with co-located organizations, such as public health clinics, to provide healthcare. This approach takes advantage of existing medical infrastructure, but still requires significant SSP-led navigation efforts. 2) SSPs are expanding strategies to deliver health services where PWUD live, primarily through mobile delivery of services, and 3) maintaining any medical staffing at SSPs is challenging given turnover and inability to pay at a competitive rate.
Conclusion: Most SSPs rely on partnerships with other organizations to provide co-located health services because integrating services into the SSP itself would be too costly. Given that SSPs are places to engage PWUD in low stigma healthcare, more support and funding is needed for collaborations between SSPs and healthcare organizations, as well as for mobile services, to expand primary care and substance use disorder treatment engagement for PWUD in the US.
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