Backpack needle exchange: background, design, and pilot testing of a program in Rhode Island

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Prevention

Background:

• Many people who inject drugs do not utilize existing needle and syringe exchange programs.
• Barriers to access include operational issues, limited hours, inconvenient locations, and lack of transportation.
• Improved access to sterile needles is vital for preventing human immunodeficiency virus (HIV) and other blood-borne virus transmission.

Purpose of the Study:

• To evaluate a novel backpack needle exchange outreach model as a method to reach underserved populations of people who inject drugs.
• To compare the characteristics of participants in a backpack needle exchange program with those using a fixed-site exchange.

Main Methods:

• A backpack needle exchange outreach model was implemented in Providence, Rhode Island.
• Participants completed surveys assessing demographics, drug injection frequency, and service utilization.
• Data were compared between backpack exchange participants and clients of a traditional storefront needle exchange.

Main Results:

• Backpack needle exchange participants were significantly more likely to be Hispanic compared to storefront exchange clients.
• Individuals using the backpack exchange reported injecting drugs more frequently than those using the fixed site.
• The backpack model demonstrated feasibility in reaching populations with limited access to traditional services.

Conclusions:

• A backpack needle exchange is a feasible and effective strategy for providing sterile needles and referrals to hard-to-reach populations of people who inject drugs.
• This mobile outreach model can help overcome barriers associated with fixed-site needle exchange programs.
• Expanding access points, such as through mobile services, is important for comprehensive HIV and blood-borne virus prevention efforts.