SSP use was disproportionately low among Black participants irrespective of injection drug use, and while SSPs offer opportunity to address elevated STI risk among people who use drugs, they may miss certain intersecting gender, race, and ethnic groups.
SSP use was disproportionately low among Black participants regardless of injection drug use status.
Women who reported SSP use had a higher prevalence of multiple sexual and reproductive health risk indicators compared to women who did not use SSP.
Among men, sexual and reproductive health outcomes varied across racial and ethnic groups but did not vary as clearly by SSP use.
People who use drugs experience elevated sexual and reproductive health risk and face barriers to accessing related services.
SSPs represent a potential opportunity to address elevated STI risk among people who use drugs, but may fail to reach certain intersecting gender, race, and ethnic subgroups.
This research examined whether syringe services programs (SSPs) — which provide clean needles and other services to people who use drugs — are reaching people who also have sexual and reproductive health needs. The study surveyed 120 people in New York City who use unprescribed opioids between late 2021 and mid-2022, looking at who uses SSPs and what their sexual health risks look like. A key finding was that Black participants were much less likely to use SSPs than other racial and ethnic groups, regardless of whether they injected drugs, suggesting these programs are not equitably reaching all communities. The study also found that women who did use SSPs tended to have higher rates of risky sexual behaviors and STI-related concerns — such as having multiple or casual partners, engaging in sex trade, and lacking effective STI prevention — compared to women who did not use SSPs. However, women who didn't use SSPs still had meaningful levels of sexual health risk, particularly when broken down by race and ethnicity, suggesting they are a population being missed by current services. Among men, sexual health risks differed more by race and ethnicity than by SSP use. This research suggests that while SSPs have real potential to serve as hubs for integrated sexual and reproductive healthcare for people who use drugs, there are significant gaps in who these programs currently reach. In particular, Black community members and women who don't already use SSPs may be missing out on services that could benefit their health. The findings point to a need for SSPs to actively work to engage underrepresented groups, including through culturally tailored outreach strategies.
Scheidell J, Chueng T, Ciraldo K, Hervera B, Dakoulas S, Mahachi M, et al.. (2024). Reaching people who use drugs with sexual and reproductive healthcare through syringe services programs: potential promise and missed opportunities.. Harm reduction journal. https://doi.org/10.1186/s12954-024-01116-5