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. 2025 Jun 26:16:100355.
doi: 10.1016/j.dadr.2025.100355. eCollection 2025 Sep.

On-site health service delivery models at syringe services programs in the United States: Results of a national cross-sectional survey

Czarina N Behrends  1 , Don C Des Jarlais  2 , Winston Luhur  1 , Xinlin Lu  2 , Grace J Corry  1 , Sara N Glick  3 , Shashi N Kapadia  1   4 , David C Perlman  5 , Bruce R Schackman  1
Affiliations

On-site health service delivery models at syringe services programs in the United States: Results of a national cross-sectional survey

Czarina N Behrends et al. Drug Alcohol Depend Rep. .

Abstract

Background: People who inject drugs (PWID) have many needs for health services, but frequently lack access to and/or do not utilize those services. Syringe services programs (SSPs) are low-stigma environments where health services can be provided, but are not well described.

Objective: We characterized types of health services delivery available at syringe services programs (SSPs) nationally and assess SSP characteristics associated with them.

Methods: Using a national survey of SSPs on services provided in 2019 (N = 153), we conducted latent class analysis to determine the best fit model for health service delivery types. We examined the association between health delivery types and SSP organizational characteristics using multinomial logistic regression.

Results: A 3-class model was best fit and included 1) a comprehensive care model that had a high probability of offering multiple health services (11 %), 2) a testing and wound care model that offers mostly HIV/HCV testing and wound care (57 %), and 3) a minimal or no health services model that predominantly do no offer medical services (32 %). Comprehensive care and HIV/HCV testing and wound care SSPs were significantly more likely to have ≥ 50 % of their funding from public sources (OR=13.7 and OR=18.0), be a larger program (4th quartile in syringe distribution, OR=25.2 and OR=4.7), and less likely to be a grassroots program (OR=0.1 for both) compared to minimal care SSPs.

Conclusions: With 11 % of SSPs providing comprehensive care and one-third providing minimal services, there is an opportunity to expand health care services at SSPs with further public funding investments.

Keywords: HCV; HIV; Harm reduction; Health services; Syringe services programs.

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Conflict of interest statement

Dr. Kapadia has received research grants to his institution from Gilead Sciences Inc, unrelated to the current work. The other authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Types and number of health services provided on-site (excluding HIV and HCV testing) from a 2019 sample of syringe service programs in the United States (N = 151).
Fig. 2
Fig. 2
Probability of offering each on-site medical service for three syringe services health models identified through latent class analysis from a 2019 sample of syringe services programs in the United States (N = 151).
See this image and copyright information in PMC

References

    1. Akiba C.F., Smith J., Wenger L.D., Morris T., Patel S.V., Bluthenthal R.N., Tookes H.E., LaKosky P., Kral A.H., Lambdin B.H. Financial barriers, facilitators, and strategies among syringe services programs in the U.S., and their impact on implementation and health outcomes. Ssm. Qual. Res. Health. 2024;5 doi: 10.1016/j.ssmqr.2024.100421. - DOI - PMC - PubMed
    1. Artenie A.A., Jutras-Aswad D., Roy É., Zang G., Bamvita J.M., Lévesque A., Bruneau J. Visits to primary care physicians among persons who inject drugs at high risk of hepatitis C virus infection: room for improvement. J. Viral Hepat. 2015;22(10):792–799. doi: 10.1111/jvh.12393. - DOI - PubMed
    1. Austin E.J., Tsui J.I., Barry M.P., Tung E., Glick S.N., Ninburg M., Williams E.C. Health care-seeking experiences for people who inject drugs with hepatitis C: qualitative explorations of stigma. J. Subst. Abus. Treat. 2022;137 doi: 10.1016/j.jsat.2021.108684. - DOI - PMC - PubMed
    1. Bartholomew T.S., Andraka-Cristou B., Totaram R.K., Harris S., Doblecki-Lewis S., Ostrer L., Serota D.P., Forrest D.W., Chueng T.A., Suarez E., Tookes H.E. We want everything in a one-stop shop: acceptability and feasibility of PrEP and buprenorphine implementation with mobile syringe services for Black people who inject drugs. Harm Reduct. J. 2022;19(1):133. doi: 10.1186/s12954-022-00721-6. - DOI - PMC - PubMed
    1. Behrends C.N., Lu X., Corry G.J., LaKosky P., Prohaska S.M., Glick S.N., Kapadia S.N., Perlman D.C., Schackman B.R., Des Jarlais D.C. Harm reduction and health services provided by syringe services programs in 2019 and subsequent impact of COVID-19 on services in 2020. Drug Alcohol Depend. 2022;232 doi: 10.1016/j.drugalcdep.2022.109323. - DOI - PMC - PubMed

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