ArticleJournal of general internal medicine2021
"Health Is on the Back Burner:" Multilevel Barriers and Facilitators to Primary Care Among People Who Inject Drugs.
Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 1 synthesis or guideline pooled it, 117 citations in OpenAlex.
- Sexually transmitted infection prevalence and testing coverage among people who inject drugs: A systematic review.Drug and alcohol dependence · 2025Pooled it
- Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: a pilot study.Harm reduction journal · 2024Trial
- Dalba Got Back? Use of Dalbavancin for the Treatment of Vertebral Osteomyelitis.Open forum infectious diseases · 2024Trial
- Preliminary Efficacy of a Theory-Informed Intervention to Increase COVID-19 Testing Uptake Among People Who Inject Drugs in San Diego County: Findings From a Pilot Randomized Controlled Trial.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2023Trial
- HCV communication within ego-centric networks of men and women who inject drugs.Drug and alcohol dependence · 2021Trial
- A randomized controlled trial of a brief behavioral intervention to reduce skin and soft tissue infections among people who inject drugs.Drug and alcohol dependence · 2021Trial
- Examining the Sustained Impact of California's Tobacco Free for Recovery Initiative: Qualitative Perspectives from Program Directors.Substance use & misuse · 2026Article
- Developing Longitudinal Post-Overdose Care: A Call to Action.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Article
- Multisite Mobile Addiction Services: Four-Year Outcomes.International journal of environmental research and public health · 2026Article
- Syringe Services Participants' Preferences for Wound Care, HIV/Hepatitis C Virus Screening, and Opioid Use Disorder Treatment: A Discrete Choice Experiment.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2026Article
- Findings from the Process Evaluation of a Mobile Health Clinic Designed to Improve Equity of Access to Primary Healthcare for People with Substance Use Disorders and/or Homelessness in One Region in the North East of England, UK.Healthcare (Basel, Switzerland) · 2026Article
- Perspectives on hepatitis A and B screening and immunization at a syringe services program: a mixed-methods study.Harm reduction journal · 2026Article
- An online stigma reduction education program for healthcare workers working with people who inject drugs: Development.PloS one · 2026Article
- Responding to the increase in substance use, HIV, HCV, and overdose in New England (RISE-NE): Protocol for a prospective cohort study.PloS one · 2026Article
- Mental Health Status and Healthcare Utilization Inequity Among People Living With HIV: A Cross-Sectional Study Using Inverse Probability Treatment Weighting.Depression and anxiety · 2026Article
- The impact of opioid agonist treatment on the incidence of bacterial sexually transmitted infection notifications among people with a history of opioid dependence in New South Wales, Australia: A retrospective data linkage study.Drug and alcohol dependence · 2025Article
- Rapid initiation of antiretrovirals at a syringe services program for people with HIV who inject drugs.Annals of medicine · 2025Article
- Access to Healthcare Among Young Adult Probationers Participating in a Pilot Health-Focused Reentry Program.International journal of offender therapy and comparative criminology · 2025Article
- Reducing stigma in primary care toward people who use drugs: A pilot study exploring the promise and limits of stigma training.Journal of substance use and addiction treatment · 2025Article
- Linkage to hepatitis C virus care in a binational cohort study of People who inject drugs on the U.S.-Mexico border.The International journal on drug policy · 2025Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe estimated 2.2 million people who inject drugs (PWID) in the USA experience significant gaps in preventive healthcare and a high burden of infectious, psychiatric, and other chronic diseases. Many PWID rely on emergency medical services, which are costly and not designed to deliver preventive services, manage chronic conditions, or address social needs.
objectiveThe objective of this study was to explore barriers and facilitators to primary care utilization from the perspectives of PWID in New England, a region highly affected by the overdose crisis.
designParticipants completed semi-structured qualitative interviews exploring substance use and healthcare utilization patterns.
participantsWe recruited 78 PWID through community-based organizations (e.g., syringe service programs) in 16 urban and non-urban communities throughout Massachusetts and Rhode Island. APPROACH: Thematic analysis identified barriers and facilitators to primary care utilization at the individual, interpersonal, and systemic levels. KEY
resultsAmong 78 PWID, 48 described recent primary care experiences; 33 had positive experiences and 15 described negative experiences involving discrimination or mistrust. Individual-level barriers to primary care utilization included perceived lack of need and competing priorities (e.g., avoiding opioid withdrawal, securing shelter beds). Interpersonal-level barriers included stigma and perceived low quality of care for PWID. Systemic-level barriers included difficulty navigating healthcare systems, inadequate transportation, long wait times, and frequent provider turnover. Participants with positive primary care experiences explained how appointment reminders, flexible hours, addiction medicine-trained providers, case management services, and transportation support facilitated primary care utilization and satisfaction.
conclusionsFindings regarding the multilevel barriers and facilitators to accessing primary care among PWID identify potential targets for programmatic interventions to improve primary care utilization in this population. Based on these findings, we make recommendations for improving the engagement of PWID in primary care as a means to advance individual and public health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.