ArticlePloS one2018
Qualitative case study of needle exchange programs in the Central Appalachian region of the United States.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Who cites it
13 citing papers in PubMed, 29 citations in OpenAlex.
- Is Law Enforcement Support the Missing Key to Thriving Syringe Service Programs in US Rural Areas?American journal of public health · 2024Article
- Racial disparities in use of syringe service programs in King County, WA: a comparison of two cross-sectional surveys.Harm reduction journal · 2023Article
- A qualitative analysis of rural syringe service program fidelity in Appalachian Kentucky: Staff and participant perspectives.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Barriers to engaging people who use drugs in harm reduction services during the COVID-19 pandemic: A mixed methods study of syringe services program perspectives.The International journal on drug policy · 2022Article
- Families in Crisis: The Relationship Between Opioid Overdoses and Child Maltreatment in Neighborhood Areas.Journal of studies on alcohol and drugs · 2022Article
- Opioid Use Stigma: An Examination of Student Attitudes on Harm Reduction Strategies.International journal of mental health and addiction · 2022Article
- Syringe Services Programs' Role in Ending the HIV Epidemic in the U.S.: Why We Cannot Do It Without Them.American journal of preventive medicine · 2021Article
- Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky.Harm reduction journal · 2021Article
- Chronic prescription opioid use predicts stabilization on buprenorphine for the treatment of opioid use disorder.Journal of substance abuse treatment · 2020Article
- Community Perceptions of Comprehensive Harm Reduction Programs and Stigma Towards People Who Inject Drugs in Rural Virginia.Journal of community health · 2020Article
- Syringe Service Program Utilization, Barriers, and Preferences for Design in Rural Appalachia: Differences between Men and Women Who Inject Drugs.Substance use & misuse · 2020Article
- Barriers to using new needles encountered by rural Appalachian people who inject drugs: implications for needle exchange.Harm reduction journal · 2019Article
- Geographic Differences and Social Determinants of Health Among People With HIV Attributed to Injection Drug Use, United States, 2017.Public health reports (Washington, D.C. : 1974)Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe Central Appalachian region of the United States is in the midst of a hepatitis C virus epidemic driven by injection of opioids, particularly heroin, with contaminated syringes. In response to this epidemic, several needle exchange programs (NEP) have opened to provide clean needles and other supplies and services to people who inject drugs (PWID). However, no studies have investigated the barriers and facilitators to implementing, operating, and expanding NEPs in less populous areas of the United States.
methodsThis qualitative case study consisted of interviews with program directors, police chiefs, law enforcement members, and PWID affiliated with two NEPs in the rural state of West Virginia. Interview transcripts were coded inductively and analyzed using qualitative data analysis software. Final common themes related to barriers and facilitators of past program openings, current program operations, and future program plans, were derived through a consensus of two data coders.
resultsBoth NEPs struggled to find existing model programs, but benefited from broad community support that facilitated implementation. The largest operational barrier was the legal conundrum created by paraphernalia laws that criminalize syringe possession. However, both PWID and law enforcement appreciated the comprehensive services provided by these programs. Program location and transportation difficulties were additional noted barriers. Future program operations are threatened by funding shortages and bans, but necessitated by unexpected program demand.
conclusionDespite broad community support, program operations are threatened by growing participant volumes, funding shortages, and the federal government's prohibition on the use of funds to purchase needles. Paraphernalia laws create a legal conundrum in the form of criminal sanctions for the possession of needles, which may inadvertently promote needle sharing and disease transmission. Future studies should examine additional barriers to using clean needles provided by rural NEPs that may blunt the effectiveness of NEPs in preventing disease transmission.
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