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02.01.2024 | Original Paper

A Qualitative Analysis of Barriers to Accessing HIV Prevention Services During an HIV Outbreak among Persons who Inject Drugs in West Virginia

verfasst von: Rebecca B. Hershow, Nancy Worthington, Monica Adams, Robert McDonald, Suzanne Wilson, Shannon McBee, Shawn Balleydier, Kathryn G. Curran

Erschienen in: AIDS and Behavior | Ausgabe 2/2024

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Abstract

In response to an increase in HIV diagnoses among persons who inject drugs (PWID) in Kanawha County, West Virginia, West Virginia Bureau for Public Health and CDC conducted a qualitative assessment in Kanawha County to inform HIV outbreak response activities. Interviews with 26 PWID and 45 community partners were completed. Transcribed interviews were analyzed to identify barriers to accessing HIV prevention services among PWID using the risk environment framework. Participants identified numerous political, physical, social, and economic community-level barriers that influenced access to HIV prevention services among PWID. Political factors included low community support for syringe services programs (SSPs); physical factors included low SSP coverage, low coverage of HIV testing outreach events, low HIV preexposure prophylaxis availability, and homelessness; social factors included stigma and discrimination; economic factors included community beliefs that SSPs negatively affect economic investments and limited resources for HIV screening in clinical settings. Individual-level barriers included co-occurring acute medical conditions and mental illness. Community-level interventions, such as low-barrier one-stop shop models, are needed to increase access to sterile syringes through comprehensive harm reduction services.

45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.

CDC. HIV surveillance report. 2018 (Updated). 2020;31. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html.

CDC. HIV/AIDS surveillance report. 1994;6(no.2). https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-1994-vol-6-2.pdf.

Lyss SB, Buchacz K, McClung RP, Asher A, Oster AM. Responding to outbreaks of Human Immunodeficiency Virus among persons who inject drugs-United States, 2016–2019: perspectives on recent experience and lessons learned. J Infect Dis. 2020;222(Suppl 5):239–S49. https://doi.org/10.1093/infdis/jiaa112.CrossRef

Strathdee SA, Kuo I, El-Bassel N, Hodder S, Smith LR, Springer SA. Preventing HIV outbreaks among people who inject drugs in the United States: plus ca change, plus ca meme chose. AIDS. 2020;34(14):1997–2005. https://doi.org/10.1097/QAD.0000000000002673.CrossRefPubMed

Casillas SM, Pickens CM, Stokes EK, Walters J, Vivolo-Kantor A. Patient-level and county-level trends in nonfatal opioid-involved overdose emergency medical services encounters – 491 counties, United States, January 2018-March 2022. MMWR Morb Mortal Wkly Rep. 2022;71(34):1073–80. https://doi.org/10.15585/mmwr.mm7134a1.CrossRefPubMedPubMedCentral

Jones CM, Logan J, Gladden RM, Bohm MK. Vital signs: demographic and substance use trends among heroin users - United States, 2002–2013. MMWR Morb Mortal Wkly Rep. 2015;64(26):719–25.PubMedPubMedCentral

Mattson CL, Tanz LJ, Quinn K, Kariisa M, Patel P, Davis NL. Trends and geographic patterns in drug and synthetic opioid overdose deaths - United States, 2013–2019. MMWR Morb Mortal Wkly Rep. 2021;70(6):202–7. https://doi.org/10.15585/mmwr.mm7006a4.CrossRefPubMedPubMedCentral

O’Donnell J, Tanz LJ, Gladden RM, Davis NL, Bitting J. Trends in and characteristics of drug overdose deaths involving illicitly manufactured fentanyls - United States, 2019–2020. MMWR Morb Mortal Wkly Rep. 2021;70(50):1740–6. https://doi.org/10.15585/mmwr.mm7006a4.CrossRefPubMedPubMedCentral

Rudd RA, Aleshire N, Zibbell JE, Gladden RM. Increases in drug and opioid overdose deaths–United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2016;64(50–51):1378–82. https://doi.org/10.15585/mmwr.mm6450a3.CrossRefPubMed

10.

Levitt A, Mermin J, Jones CM, See I, Butler JC. Infectious diseases and injection drug use: public health burden and response. J Infect Dis. 2020;222(Suppl 5):S213–S217. https://doi.org/10.1093/infdis/jiaa432.CrossRef

11.

Broz D, Carnes N, Chapin-Bardales J, Des Jarlais DC, Handanagic S, Jones CM, et al. Syringe services programs’ role in ending the HIV epidemic in the U.S.: why we cannot do it without them. Am J Prev Med. 2021;61(5 Suppl 1):S118–S129. https://doi.org/10.1016/j.amepre.2021.05.044.CrossRef

12.

Bluthenthal RN, Anderson R, Flynn NM, Kral AH. Higher syringe coverage is associated with lower odds of HIV risk and does not increase unsafe syringe disposal among syringe exchange program clients. Drug Alcohol Depend. 2007;89(2–3):214–22. https://doi.org/10.1016/j.drugalcdep.2006.12.035.CrossRefPubMedPubMedCentral

13.

Kerr T, Small W, Buchner C, Zhang R, Li K, Montaner J, Wood E. Syringe sharing and HIV incidence among injection drug users and increased access to sterile syringes. Am J Public Health. 2010;100(8):1449–53. https://doi.org/10.2105/ajph.2009.178467.CrossRefPubMedPubMedCentral

14.

CDC. Needs-Based distribution at syringe services programs. 2020. https://www.cdc.gov/ssp/docs/CDC-SSP-Fact-Sheet-508.pdf

15.

Hyshka E, Strathdee S, Wood E, Kerr T. Needle exchange and the HIV epidemic in Vancouver: lessons learned from 15 years of research. Int J Drug Policy. 2012;23(4):261–70. https://doi.org/10.1016/j.drugpo.2012.03.006.CrossRefPubMedPubMedCentral

16.

Bartholomew TS, Tookes HE, Bullock C, Onugha J, Forrest DW, Feaster DJ. Examining risk behavior and syringe coverage among people who inject drugs accessing a syringe services program: a latent class analysis. Int J Drug Policy. 2020;78:102716. https://doi.org/10.1016/j.drugpo.2020.102716.CrossRefPubMedPubMedCentral

17.

Edland-Gryt M, Skatvedt AH. Thresholds in a low-threshold setting: an empirical study of barriers in a centre for people with drug problems and mental health disorders. Int J Drug Policy. 2013;24(3):257–64. https://doi.org/10.1016/j.drugpo.2012.08.002.CrossRefPubMed

18.

Javed Z, Burk K, Facente S, Pegram L, Ali A, Asher A. Syringe services programs: a technical package of effective strategies and approaches for planning, design, and implementation. Atlanta, GA: US Department of Health and Human Services, National Center for HIV/AIDS, viral hepatitis, STD and TB prevention, centers for disease control and prevention. 2020. https://www.cdc.gov/ssp/docs/SSP-Technical-Package.pdf.

19.

Fernandez-Vina MH, Prood NE, Herpolsheimer A, Waimberg J, Burris S. State laws governing syringe services programs and participant syringe possession, 2014–2019. Public Health Rep. 2020;135(1suppl):128S–37S. https://doi.org/10.1177/0033354920921817.CrossRefPubMedPubMedCentral

20.

Ibragimov U, Cooper KE, Batty E, Ballard AM, Fadanelli M, Gross SB, et al. Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky. Harm Reduct J. 2021;18(1):68. https://doi.org/10.1186/s12954-021-00518-z.

21.

United States Census Bureau. Kanawha County, West Virginia. https://www.census.gov/quickfacts/kanawhacountywestvirginia

22.

West Virginia Department of Health & Human Resources Office of Drug Control Policy. Data Dashboard. 2022. https://dhhr.wv.gov/office-of-drug-control-policy/datadashboard/Pages/default.aspx

23.

West Virginia Department of Health & Human Resources Bureau for Public Health. Health advisory #162: Human Immunodeficiency Virus (HIV) infections among people who inject drugs --additional area seeing increase, others vulnerable. 2019. https://oeps.wv.gov/healthalerts/documents/wv/WVHAN_162.pdf.

24.

Hershow RB, Wilson S, Bonacci RA, Deutsch-Feldman M, Russell OO, Young S, et al. Notes from the field: HIV outbreak during the COVID-19 pandemic among persons who inject drugs - Kanawha County, West Virginia, 2019–2021. MMWR Morb Mortal Wkly Rep. 2022;71(2):66–8. https://doi.org/10.15585/mmwr.mm7102a4.CrossRefPubMedPubMedCentral

25.

Hodousek C. Charleston mayor says implementing needle exchange program was a mistake. MetroNews. 2018. https://wvmetronews.com/2018/03/14/charleston-mayor-says-implementing-needle-exchange-program-was-a-mistake/.

26.

Jones D. In: Young R, editor. You don’t sacrifice a whole city’ over needle exchange, West Virginia mayor says. Here & Now: WBUR. 2018. https://www.wbur.org/hereandnow/2018/05/15/needle-exchange-charleston-west-virginia.

27.

Katz J. Why a city at the center of the opioid crisis gave up a tool to fight it. The New York Times. 2018. https://www.nytimes.com/interactive/2018/04/27/upshot/charleston-opioid-crisis-needle-exchange.html.

28.

Lurie J. HIV is on the loose in West Virginia, and so is a moral panic about needle exchanges. Mother Jones. 2021. https://www.motherjones.com/politics/2021/04/hiv-is-on-the-loose-in-west-virginia-and-so-is-a-moral-panic-about-needle-exchanges/.

29.

CDC. Summary of information on the safety and effectiveness of syringe services programs (SSPs). 2023. https://www.cdc.gov/ssp/syringe-services-programs-summary.html

30.

Galea S, Ahern J, Fuller C, Freudenberg N, Vlahov D. Needle exchange programs and experience of violence in an inner city neighborhood. J Acquir Immune Defic Syndr. 2001;28(3):282–8. https://doi.org/10.1097/00042560-200111010-00014.CrossRefPubMed

31.

Levine H, Bartholomew TS, Rea-Wilson V, Onugha J, Arriola DJ, Cardenas G, et al. Syringe disposal among people who inject drugs before and after the implementation of a syringe services program. Drug Alcohol Depend. 2019;202:13–7. https://doi.org/10.1016/j.drugalcdep.2019.04.025.CrossRefPubMedPubMedCentral

32.

Marx MA, Crape B, Brookmeyer RS, Junge B, Latkin C, Vlahov D, Strathdee SA. Trends in crime and the introduction of a needle exchange program. Am J Public Health. 2000;90(12):1933–6. https://doi.org/10.2105/ajph.90.12.1933.CrossRefPubMedPubMedCentral

33.

Wenger LD, Martinez AN, Carpenter L, Geckeler D, Colfax G, Kral AH. Syringe disposal among injection drug users in San Francisco. Am J Public Health. 2011;101(3):484–6. https://doi.org/10.2105/ajph.2009.179531.CrossRefPubMedPubMedCentral

34.

Allen ST, Grieb SM, O’Rourke A, Yoder R, Planchet E, White RH, Sherman SG. Understanding the public health consequences of suspending a rural syringe services program: a qualitative study of the experiences of people who inject drugs. Harm Reduct J. 2019;16(1):33. https://doi.org/10.1186/s12954-019-0305-7.CrossRefPubMedPubMedCentral

35.

Peace L. When a West Virginia county eliminated its needle exchange, experts forewarned of an HIV crisis. Now it’s here. Mountain State Spotlight. 2020. https://mountainstatespotlight.org/2020/12/15/when-a-west-virginia-county-eliminated-its-needle-exchange-experts-forewarned-of-an-hiv-crisis-now-its-here/.

36.

SOAR to halt needle exchange services. WSAZ News. 2021. https://www.wsaz.com/2021/04/07/soar-to-halt-needle-exchange-services/.

37.

Dindak D. Unanimous vote continues the work of the only needle exchange in Kanawha County. Eyewitness News. 2021. https://wchstv.com/news/local/unanimous-vote-continues-the-work-of-the-only-needle-exchange-in-kanawha-county.

38.

National coordinating council for medication error reporting and prevention. recommendations for bar code labels on pharmaceutical. (Drug) products to reduce medication errors. 2023. https://www.nccmerp.org/recommendations-bar-code-labels-pharmaceutical-drug-products-reduce-medication-errors

39.

Bonacci RA, Moorman AC, Bixler D, Penley M, Wilson S, Hudson A, McClung RP. Prevention and care opportunities for people who inject drugs in an HIV outbreak — Kanawha County, West Virginia, 2019–2021. J Gen Intern Med. 2023;38(3):828–31. https://doi.org/10.1007/s11606-022-07875-w.

40.

West Virginia Legislature. Senate Bill 334. 2021. https://www.wvlegislature.gov/Bill_Text_HTML/2021_SESSIONS/RS/signed_bills/senate/SB334%2520SUB1%2520ENR_signed.pdf.

41.

Council of the City of Charleston. Bill No. 7893. 2021. https://library.municode.com/wv/charleston/ordinances/code_of_ordinances?nodeId=1080097.

42.

Rhodes T. Risk environments and drug harms: a social science for harm reduction approach. Int J Drug Policy. 2009;20(3):193–201. https://doi.org/10.1016/j.drugpo.2008.10.003.CrossRefPubMed

43.

Rhodes T, Simic M. Transition and the HIV risk environment. BMJ. 2005;331(7510):220–3. https://doi.org/10.1136/bmj.331.7510.220.CrossRefPubMedPubMedCentral

44.

Strathdee SA, Hallett TB, Bobrova N, Rhodes T, Booth R, Abdool R, Hankins CA. HIV and risk environment for injecting drug users: the past, present, and future. Lancet. 2010;376(9737):268–84. https://doi.org/10.1016/s0140-6736(10)60743-x.CrossRefPubMedPubMedCentral

45.

Rhodes T. The risk environment: a framework for understanding and reducing drug-related harm. Int J Drug Policy. 2002:85–94. https://doi.org/10.1016/S0955-3959(02)00007-5.

46.

Aspinall EJ, Nambiar D, Goldberg DJ, Hickman M, Weir A, Van Velzen E, et al. Are needle and syringe programmes associated with a reduction in HIV transmission among people who inject drugs: a systematic review and meta-analysis. Int J Epidemiol. 2014;43(1):235–48. https://doi.org/10.1093/ije/dyt243.CrossRefPubMed

47.

CDC. CDC health advisory: recent HIV clusters and outbreaks across the United States among people who inject drugs and considerations during the COVID-19 pandemic. 2020. https://stacks.cdc.gov/view/cdc/94797.

48.

HHS. Department of health and human services implementation guidance to support certain components of syringe services programs, 2016. 2016. https://www.cdc.gov/hiv/pdf/risk/hhs-ssp-guidance.pdf.

49.

Jason J. Community-acquired, non-occupational needlestick injuries treated in US Emergency Departments. J Public Health (Oxf). 2013;35(3):422–30. https://doi.org/10.1093/pubmed/fdt033.CrossRefPubMed

50.

Joyce MP, Kuhar D, Brooks JT. Notes from the field: occupationally acquired HIV infection among health care workers - United States, 1985–2013. MMWR Morb Mortal Wkly Rep. 2015;63(53):1245–6.PubMedPubMedCentral

51.

Patel MR, Foote C, Duwve J, Chapman E, Combs B, Fry A, et al. Reduction of injection-related risk behaviors after emergency implementation of a syringe services program during an HIV outbreak. J Acquir Immune Defic Syndr. 2018;77(4):373–82. https://doi.org/10.1097/qai.0000000000001615.CrossRefPubMed

52.

Schulkind J, Stephens B, Ahmad F, Johnston L, Hutchinson S, Thain D, et al. High response and re-infection rates among people who inject drugs treated for hepatitis C in a community needle and syringe programme. J Viral Hepat. 2019;26(5):519–28. https://doi.org/10.1111/jvh.13035.CrossRefPubMed

53.

Strathdee SA, Ricketts EP, Huettner S, Cornelius L, Bishai D, Havens JR, et al. Facilitating entry into drug treatment among injection drug users referred from a needle exchange program: results from a community-based behavioral intervention trial. Drug Alcohol Depend. 2006;83(3):225–32. https://doi.org/10.1016/j.drugalcdep.2005.11.015.CrossRefPubMed

54.

Degenhardt L, Mathers B, Vickerman P, Rhodes T, Latkin C, Hickman M. Prevention of HIV infection for people who inject drugs: why individual, structural, and combination approaches are needed. Lancet. 2010;376(9737):285–301. https://doi.org/10.1016/s0140-6736(10)60742-8.CrossRefPubMed

55.

Branson BM, Handsfield HH, Lampe MA, Janssen RS, Taylor AW, Lyss SB, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recomm Rep. 2006;55(RR–14):1–17. quiz CE1-4.PubMed

56.

Burrell CN, Sharon MJ, Davis S, Feinberg J, Wojcik EM, Nist J, et al. Using the electronic medical record to increase testing for HIV and hepatitis C virus in an Appalachian emergency department. BMC Health Serv Res. 2021;21(1):524. https://doi.org/10.1186/s12913-021-06482-5.CrossRefPubMedPubMedCentral

57.

Faryar KA, Ancona RM, Reau Z, Lyss SB, Braun RS, Rademaker T, et al. HIV detection by an emergency department HIV screening program during a regional outbreak among people who inject drugs. PLoS ONE. 2021;16(5):e0251756. https://doi.org/10.1371/journal.pone.0251756.CrossRefPubMedPubMedCentral

58.

Biancarelli DL, Biello KB, Childs E, Drainoni M, Salhaney P, Edeza A, et al. Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019;198:80–6. https://doi.org/10.1016/j.drugalcdep.2019.01.037.CrossRefPubMedPubMedCentral

59.

Tsai AC, Kiang MV, Barnett ML, Beletsky L, Keyes KM, McGinty EE, et al. Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Med. 2019;16(11):e1002969. https://doi.org/10.1371/journal.pmed.1002969.CrossRefPubMedPubMedCentral

60.

Health Resources & Services Administration. Part F: AIDS Education and Training Center (AETC) program. 2022. https://ryanwhite.hrsa.gov/about/parts-and-initiatives/part-f-aetc

61.

CDC. Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services. MMWR Recomm Rep. 2012;61(RR–5):1–40.

62.

Perlman DC, Jordan AE. The syndemic of opioid misuse, overdose, HCV, and HIV: structural-level causes and interventions. Curr HIV/AIDS Rep. 2018;15(2):96–112. https://doi.org/10.1007/s11904-018-0390-3.CrossRefPubMedPubMedCentral

Titel: A Qualitative Analysis of Barriers to Accessing HIV Prevention Services During an HIV Outbreak among Persons who Inject Drugs in West Virginia
verfasst von: Rebecca B. Hershow
Nancy Worthington
Monica Adams
Robert McDonald
Suzanne Wilson
Shannon McBee
Shawn Balleydier
Kathryn G. Curran
Publikationsdatum: 02.01.2024
Verlag: Springer US
Erschienen in: AIDS and Behavior / Ausgabe 2/2024
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI: https://doi.org/10.1007/s10461-023-04254-2

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