Variation in Syringe Service Programs by Community Characteristics
Location
D.P. Culp Center Room 304
Start Date
4-5-2024 2:30 PM
End Date
4-5-2024 3:30 PM
Name of Project's Faculty Sponsor
Casey Balio
Faculty Sponsor's Department
Health Services Management and Policy
Competition Type
Competitive
Type
Oral Presentation
Presentation Category
Health
Abstract or Artist's Statement
Background: Syringe service programs (SSP) have been proven to reduce transmission of viral infections such as HIV and hepatitis C, prevent substance use and overdose death, and help support public safety of the areas in which they operate. With drug abuse and overdose death numbers on the rise nationally, it is vital to invest resources into these harm reduction mechanisms. The purpose of this cross-section study was to examine the location of syringe service programs across the United States and estimate associations with community characteristics associated with presence and number of programs. Methods: SSP location data was collected through state health department websites and the North American Syringe Exchange Network (NASEN) dashboard. Additional data include Rural-Urban Continuum Codes (RUCCs) from USDA Data and demographic information about counties from the Rural Ecosystem Index. Bivariate analyses were conducted to consider presence and number of SSPs as a function of community characteristics. Results: Urban counties have significantly higher odds of containing at least one SSP when compared to rural counties, with 30% of urban counties and 12% of rural counties containing at least one such program (p<.001). There was also a significant difference between the actual number of syringe exchange programs per county by rurality. Urban counties had an average of 1.7 syringe service programs, whereas rural counties had an average of 1.17. (p < .0001). Discussion: This study elucidates differences in access to SSPs by rurality, which may be important for addressing disparities between harm reduction programs in rural and urban areas. Despite being a hotspot for drug abuse and overdose, rural areas had lower odds of having a syringe service program when compared to urban counterparts. This suggests that the needs of rural areas are not being met with adequate intervention. Despite promising results, this study had limitations. The most pertinent limitation involves the cross-sectional nature of this research, meaning that causality cannot be established. Furthermore, SSP location data were ascertained from state listings and the NASEN dashboard which may not be a complete and comprehensive listing of all programs and is reliant on those sources being current and maintained. However, this may more accurately capture availability of services to the general public. Future research should be conducted in rural areas to better understand factors limiting the presence of SSPs and other evidence-based harm reduction interventions. In addition, more nuanced analyses considering presence of SSPs as a function of measures of need such as HIV and HCV rates, policies related to accessibility of SSPs and other treatment providers, and rates of substance use. Such findings may contribute to the growing literature regarding the effectiveness of these programs and inform future policy and practice efforts to improve access to such services.
Variation in Syringe Service Programs by Community Characteristics
D.P. Culp Center Room 304
Background: Syringe service programs (SSP) have been proven to reduce transmission of viral infections such as HIV and hepatitis C, prevent substance use and overdose death, and help support public safety of the areas in which they operate. With drug abuse and overdose death numbers on the rise nationally, it is vital to invest resources into these harm reduction mechanisms. The purpose of this cross-section study was to examine the location of syringe service programs across the United States and estimate associations with community characteristics associated with presence and number of programs. Methods: SSP location data was collected through state health department websites and the North American Syringe Exchange Network (NASEN) dashboard. Additional data include Rural-Urban Continuum Codes (RUCCs) from USDA Data and demographic information about counties from the Rural Ecosystem Index. Bivariate analyses were conducted to consider presence and number of SSPs as a function of community characteristics. Results: Urban counties have significantly higher odds of containing at least one SSP when compared to rural counties, with 30% of urban counties and 12% of rural counties containing at least one such program (p<.001). There was also a significant difference between the actual number of syringe exchange programs per county by rurality. Urban counties had an average of 1.7 syringe service programs, whereas rural counties had an average of 1.17. (p < .0001). Discussion: This study elucidates differences in access to SSPs by rurality, which may be important for addressing disparities between harm reduction programs in rural and urban areas. Despite being a hotspot for drug abuse and overdose, rural areas had lower odds of having a syringe service program when compared to urban counterparts. This suggests that the needs of rural areas are not being met with adequate intervention. Despite promising results, this study had limitations. The most pertinent limitation involves the cross-sectional nature of this research, meaning that causality cannot be established. Furthermore, SSP location data were ascertained from state listings and the NASEN dashboard which may not be a complete and comprehensive listing of all programs and is reliant on those sources being current and maintained. However, this may more accurately capture availability of services to the general public. Future research should be conducted in rural areas to better understand factors limiting the presence of SSPs and other evidence-based harm reduction interventions. In addition, more nuanced analyses considering presence of SSPs as a function of measures of need such as HIV and HCV rates, policies related to accessibility of SSPs and other treatment providers, and rates of substance use. Such findings may contribute to the growing literature regarding the effectiveness of these programs and inform future policy and practice efforts to improve access to such services.