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Area of Science:

  • Public Health
  • Infectious Diseases
  • Health Services Research

Background:

  • People who inject drugs (PWID) have high risks for viral hepatitis, yet hepatitis A virus (HAV) and hepatitis B virus (HBV) prevention services are underutilized.
  • Syringe services programs (SSPs) are effective settings for delivering these services, but few currently offer them.
  • Qualitative insights into optimizing HAV and HBV services within SSPs are limited.

Purpose of the Study:

  • To explore barriers and facilitators for providing HAV and HBV prevention and care services to PWID.
  • To understand perspectives of PWID and SSP staff on optimizing these services within SSPs.
  • To identify opportunities for improving service delivery at SSPs.

Main Methods:

  • A mixed-methods study was conducted at an SSP in Miami, Florida.
  • Quantitative data on vaccine administration (August 2023-May 2025) were extracted from the SSP database.
  • Qualitative data were collected through in-depth interviews with 15 PWID and 11 SSP staff in May 2022, analyzed using thematic analysis.

Main Results:

  • The SSP administered 114 HAV and 176 HBV vaccine doses between August 2023 and May 2025.
  • Key barriers identified by PWID and staff included limited knowledge, stigma, resource/transportation challenges, and navigation difficulties.
  • Facilitators for SSP-based services were co-located, on-demand care, and a non-stigmatizing environment; opportunities included incentives and expanded outreach.

Conclusions:

  • PWID encounter substantial barriers to viral hepatitis services in traditional healthcare settings.
  • Integrating HAV and HBV services into SSPs improves accessibility and uptake by utilizing trust, convenience, and harm reduction principles.