Evidence map›Paper›PMID 41680818›Full record

SynthesisHarm reduction journal2026

Barriers and facilitators to initiating and adhering to harm reduction services among people who inject drugs in the United States: a systematic review.

Carrie L Nacht, Britt Skaathun, Kristen Ogarrio, Reanna Durbin-Matrone, Laura Wright, Rick Reich, Kat Reich, Kristefer Stojanovski

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Harm reduction journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Carrie L NachtSchool of Public Health, San Diego State University, San Diego, CA, USA.
Britt SkaathunSchool of Public Health, San Diego State University, San Diego, CA, USA. bskaathun@health.ucsd.edu.
Kristen OgarrioDepartment of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Reanna Durbin-MatroneCelia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
Laura WrightRudolph Matas Library of Health Sciences, Tulane University, New Orleans, LA, USA.
Rick ReichTrac B Exchange, Las Vegas, NV, USA.
Kat ReichTrac B Exchange, Las Vegas, NV, USA.
Kristefer StojanovskiDepartment of Social, Behavioral, and Population Sciences, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.

Funding

Training Program in Substance Use, HIV and Related InfectionsT32DA023356 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Natasha Martin, Steffanie A Strathdee · 2007 to 2026
$7.8M
Leveraging Networks, Epidemiology, and Epidemic Modeling: Creative Approaches for HIV EliminationK01DA049665 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SKAATHUN, BRITT · 2019 to 2023
$947k
NIAID NIH HHS R21 AI67889NIDA NIH HHS K01 DA049665NIDA NIH HHS R03 DA57142NIDA NIH HHS T32 DA023356NIDA NIH HHS T32DA023356Robert Wood Johnson Foundation 78477
6 · The paper itself

Abstract

backgroundHarm reduction services are inequitably accessible and efficient among people with a history of injection drug use (PWHID), particularly among those belonging to vulnerable communities. This systematic review identifies barriers and facilitators to accessing and adhering to harm reduction services among PWHID in priority populations to gain a deeper understanding of the intersectional barriers to these services.

methodsA systematic search was conducted using four databases (PubMed/MEDLINE, Scopus, CINAHL, and Web of Science) to locate articles examining barriers and/or facilitators associated with substance use harm reduction services among marginalized populations (e.g., racial/ethnic minorities, sexual/gender minorities, people living with HIV, veterans, etc.) in the United States. Study characteristics and key findings were extracted from studies and thematically analyzed.

resultsThis review identified 25 articles that examined factors associated with initiation and adherence to harm reduction services for PWHID. The harm reduction services most identified were medications for opioid use disorders (e.g., naloxone, buprenorphine) and syringe service programs. Factors were individual-level factors (e.g., motivation, stigma, previous negative experiences), as well as service-level barriers (e.g., accessibility, distance, setting). Many studies identified participant sociodemographic characteristics (e.g., race, age, sexuality) as a facilitator or barrier, although these factors are proxies for systemic and/or structural barriers and should not necessarily be considered as intervention targets.

conclusionIncorporating harm reduction services as part of integrated, wraparound services in other healthcare settings may reduce barriers such as convenience, inaccessibility due to geography or transportation, stigma, and encourage service utilization as a result.

Indexed as

Harm ReductionHealth Services AccessibilitySubstance Abuse, IntravenousHumansUnited StatesHarm reductionPeople who inject drugsSubstance abuseSubstance use treatment services

Identifiers

PMID41680818
PMCPMC13005311

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.