Were Needles Everywhere?: Differing Views on Syringe Waste and Disposal Associated With Needs-Based Syringe Services Programs Among Community Partners and Persons Who Inject Drugs

Abstract

Background

Community concerns surrounding syringe waste are a common barrier to syringe services program (SSP) implementation. In Kanawha County, West Virginia, community opposition to SSPs resulted in the closure of needs-based SSPs prior to and during an HIV outbreak among persons who inject drugs (PWID). This qualitative analysis examines views of PWID and community partners on syringe waste and disposal associated with needs-based SSPs.

Methods

Qualitative interviews with 26 PWID and 45 community partners (medical and social service providers, law enforcement personnel, policymakers, and religious leaders) were conducted. Interviews were recorded, transcribed, and coded. Code summaries described participants’ views on syringe waste and disposal and needs-based SSPs.

Results

Community partners and PWID who favored needs-based SSPs reported that needs-based SSPs had not affected or reduced syringe waste. Conversely, community partners who favored one-to-one exchange models and/or barcoded syringes described needs-based SSPs increasing syringe waste. Community partners often cited pervasive community beliefs that SSPs increased syringe waste, risk of needlesticks, drug use, and crime. Community partners were unsure how to address syringe waste concerns and emphasized that contradictory views on syringe waste posed barriers to discussing and implementing SSPs.

Conclusions

Participants’ views on whether syringe waste was associated with needs-based SSPs often aligned with their support or opposition for needs-based SSPs. These differing views resulted in challenges finding common ground to discuss SSP operations amid an HIV outbreak among PWID. SSPs might consider addressing syringe waste concerns by expanding syringe disposal efforts and implementing community engagement and stigma reduction activities.

Keywords:

• Persons who inject drugs
• syringe waste
• syringe disposal
• syringe services programs
• harm reduction
• qualitative research

Acknowledgments

We gratefully acknowledge the contributions of the interview participants. We would also like to acknowledge the contributions and support provided by the following individuals and organizations: Sherri Young, Kanawha-Charleston Health Department; Terrie Lee, Christine Teague, Ryan White Part C Clinic, Charleston Area Medical Center; Rhonda Francis, Angie Settle, West Virginia Health Right; Miracle Boltz, Vicki Hogan, Lindsey Mason, Erica Thomasson, Margret Watkins, Melody Wilkinson, Bureau for Public Health, West Virginia Department of Health and Human Resources; Alice Asher, Danae Bixler, Robert Bonacci, Sharoda Dasgupta, Molly Deutsch-Feldman, Laura Eastham, Robyn Neblett Fanfair, Anne Marie France, Senad Handanagic, Brandon Hugueley, Randy Jefferson, Christopher Jones, Stephen Kowalewski, Chang Lee, R. Paul McClung, Pete Moore, Ann Moorman, Ken Myers, Alexandra M. Oster, McKenna Penley, Stephen Perez, Olivia Russell, Melinda Salmon, Phillip P. Salvatore, Janet Scott, Rachel Wingard, CDC.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The interview participants did not give consent for the interview transcripts to be shared publicly, so due to the sensitive nature of the research supporting data is not available.

Notes

1 45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.