Evaluation of a Syringe Exchange Program in a Mid-sized Semi-rural County: Analyses of Client Demographics, Drug Use and Syringe Sharing Behaviors

By Dominic Picetti, Janelle Barbier, Lois Petty, Soma Roy and Candace Winstead.

Published by The International Journal of Health, Wellness and Society

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Background: Syringe exchange is a highly effective method of harm reduction, helping to prevent blood-borne infectious diseases such as HIV and HCV among intravenous drug users (IDU)[4,6,7]. The syringe exchange program (SEP) in San Luis Obispo County, California serves an area that is primarily agricultural with small city centers. Much prior data on syringe exchange programs (SEPs) is from large urban centers making these SEP evaluation data relatively unique. Methods: Clients filled out written surveys regarding drug use and sharing behavior. Surveys were analyzed for these and other characteristics. Statistical analyses were employed to determine whether categories of clients were more or less likely to engage in risky syringe sharing behavior. Results: Clients at the SEP are predominately young, white males (18–25 years old). A significant minority of clients is in an unstable housing situation (36.9%). The most common drugs clients injected recently include heroin (52.4%), prescription opioids (32.9%), and methamphetamine (34.1%). A relatively large proportion of clients (40.5%) have shared needles or supplies within the last month. Length of time as a client was not significantly associated with whether or not sharing occurs. Frequency of injection, the number of drug categories injected and injection of prescription opioid pain medicine were significantly associated with sharing behavior (p<0.001). Clients aged 18–25 were three times more likely to share (Odds ratio (OR)=3.02; 95% Confidence Interval (CI)= 1.03, 8.84) than the reference group, likewise clients in unstable housing were almost three times more likely to share (OR=2.81; 95% CI= 1.2, 7) than those in stable housing. Conclusions: Clients continue to share syringes at a high rate despite the presence of the syringe exchange. Categories of clients reporting increases in sharing will be targeted for education and outreach. These data may also have an effect on efforts to change the SEP dispensation policies.

Keywords: Syringe Exchange Program, Intravenous Drug Users, Syringe Sharing, Harm Reduction, HIV, HCV

The International Journal of Health, Wellness and Society, Volume 2, Issue 2, pp.53-66. Article: Print (Spiral Bound). Article: Electronic (PDF File; 270.939KB).

Dominic Picetti

Undergraduate Researcher, Department of Kinesiology, California Polytechnic State University, USA

Janelle Barbier

San Luis Obispo, CA, USA

Lois Petty

Site Manager, San Luis Obispo Syringe Exchange Program

Soma Roy

Assistant Professor, Statistics Department, California Polytechnic State University, USA

Dr. Candace Winstead

Assistant Professor, Biological Sciences Department, California Polytechnic State University, San Luis Obispo, USA