Barriers to Healthcare for People Who Inject Drugs: A Survey at a Syringe Exchange Program

Abstract

Objective: Despite research demonstrating increased need for healthcare services among people who use drugs, few studies have investigated barriers to general healthcare in this population. We explored the most common barriers to general healthcare faced by clients utilizing syringe access services. Methods: Clients of Project Safe Point— a syringe access service serving Albany, NY and surrounding regions—were surveyed on their general health practices and specific health care barriers. Descriptive analyses were used to identify which barriers were most prevalent. Results: Of the clients surveyed (n = 59), the most common specific barriers were deprioritization of medical care (i.e., procrastination [80%], finding it easier to ignore the problem [63%]), cost (i.e., not having insurance [59%], not being able to afford the cost of care [58%]), transportation (53%), and judgement by clinicians (53%). When participants were asked to choose which was their biggest barrier to healthcare, judgement by clinicians was chosen more than twice as often as any other barrier. Conclusion: While people who inject drugs at a syringe access program often experience traditional barriers to healthcare (i.e., logistical barriers, procrastination), nearly a quarter of the clients reported feeling judged by clinicians as their most significant barrier. Future work in this field should explore interventions that motivate clients to seek care and that reduce stigma in healthcare interactions.

Keywords:

• Healthcare
• barriers
• drug use
• stigma

Acknowledgements

Special thanks to Sara Silberstein, MPH, for support with statistical analyses, and Project Safe Point’s Joseph Filippone, Ed Fox, all the staff and clients.

Declaration of interest

The authors report no conflict of interest.

Role of funding source

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Contributors

LM and IA conceived of and designed the study. LM and JL interviewed participants to collect data. AM and MW provided critical advising for finalizing the data and presentation. LM prepared the manuscript, and JL, AM, IA, and MW all provided important feedback to the manuscript. All authors read and approved the final manuscript.

This paper begins to clarify the prevalence of barriers to general healthcare for people who inject drugs, as well as the importance of each barrier in hindering access to care. It contains original material, not submitted, in press, or published elsewhere in any form.