Injection Behaviors and Use of Syringe Service Programs over Time among People Who Inject Drugs in Baltimore,...

Area of Science:

• Public Health
• Epidemiology
• Harm Reduction

Background:

• People who inject drugs (PWID) face elevated risks for infectious diseases like Hepatitis C and HIV.
• Understanding trends in injection behaviors and syringe service program (SSP) utilization is crucial for effective infectious disease prevention and harm reduction strategies.

Purpose of the Study:

• To examine temporal trends in specific injection risk behaviors and SSP utilization among PWID in Baltimore from 2009 to 2018.
• To identify demographic and behavioral factors associated with these trends.

Main Methods:

• Utilized data from the National HIV Behavioral Surveillance System in Baltimore, Maryland.
• Analyzed changes in receptive sharing of syringes, injection equipment, syringes for drug division, and receipt of syringes from SSPs among PWID (n=518-575 per wave).
• Employed unadjusted and adjusted logistic regression models to assess trends over time (2009, 2012, 2015, 2018).

Main Results:

• Receptive sharing of syringes and receipt of syringes from SSPs remained stable.
• Receptive sharing of injection equipment and syringes for drug division significantly decreased after 2009.
• White race and daily injection frequency were linked to higher sharing behaviors and lower SSP use. Women showed increased SSP syringe receipt and decreased sharing in 2015.

Conclusions:

• Overall trends indicate stable or decreasing injection-related risks and consistent SSP usage.
• Notable improvements in SSP engagement were observed among women.
• Persistent high-risk behaviors among White PWID necessitate targeted outreach and interventions.