BRIDGE TO SERVICES: DRUG INJECTORS' AWARENESS AND UTILIZATION OF DRUG USER TREATMENT AND SOCIAL SERVICE REFERRALS, MEDICAL CARE, AND HIV TESTING PROVIDED BY NEEDLE EXCHANGE PROGRAMS

Abstract

Using qualitative interviews conducted in 1999, we examine awareness and use of drug user treatment and social service referrals, medical care, and HIV testing provided by needle exchange programs (NEPs) among injectors who use NEPs (N = 26) and injectors who get their syringes from other sources (N = 20). A four-category typology of NEP service knowledge and use emerges from these interviews: “Active involvement”—use of services; “Steppingstone”—no use of services but knowledge that specific services are available; “Vague awareness”—nonspecific knowledge of service availability; and “Unaware:—no awareness of the service provision function of NEPs. We describe patterns of distribution of respondents among these categories and suggest policy implications.

• Needle exchange
• Service referrals
• Service provision
• Injection drug users

RESUMEN

Através de entrevistas cualitativas entre toxicómanos, examinamos el conocimiento y el uso de servicios ofrecidos por programas de cambio de jeringas (needle exchange programs = NEPs). Estos servicios son tales como: tratamientos para toxicómanos, servicios socials, asistencia médica y prueba del HIV. Los entrevistados fueron divididos en toxicómanos que participan en programas de cambio de jeringas (N = 26) y toxicómanos pque consiguen sus jeringas a través de otras fuentes (N = 20). Cuatro categorías de conocimiento y utilizo de programas de cambio de jeringas emergen de estas entrevistas: “Compromiso activo”—utilizo de servicios; “Escabel”—ningún utilizo de servicios, pero conocimiento que estos servicios específicos están disponibles; “Conocimiento vago”—conocimiento indefinido sobre la disponibilidad de servicios; y “Desprevenidos”—ningún conocimiento de la provisión de servicios por parte de los programas de cambio de jeringas. Describimos la tendencia de las respuestas de los entrevistados con estas cuatro categories y ofrecemos propuestas como optimar los programas de cambio de jeringas y ayudar a un mayor grupo de personas.

RÉSUMÉ

En utilisant qualitatifs interviews, nous étudions la connaissance et l'emploi de l'evoi chez les traitments pour les toxicomanes et chez les services sociaux, la soin médicale, et le test pour le HIV offerts par les programmes de échange de seringues entre toxicomanes qui utilisent ces programmes (N = 26) et toxicomanes qui ne utilisent pas ces programmes (N = 20). Quatre catégories de connaissance et emploi émergent de ces interviews: ≪Participation active≫—emploi des services; ≪Mauveise participation≫—aucun emploi des services, mais bonne connaissance de l'existence de ces services; ≪Connaissance vague≫—connaissance imprécise de la disponibilité des services; et ≪Dépourvus≫—aucune connaissance du rôle de offre de ces services de la part des programmes de échange de seringues. Nous déscrivons le trend de distribution des interviewés entre ces quatre catégories, en proposant des posibles implications politiques.

Additional information

Notes on contributors

Judith Porter

Judith Porter, Ph.D., is Professor of Sociology at Bryn Mawr College. She has recently studied crack addiction and HIV transmission, the ecology of HIV transmission among female sex workers, barriers to drug user treatment among Puerto Rican heroin users, and factors related to lack of use of drug user treatment among drug injectors. She volunteers as an AIDS educator with Congreso de Latinos Unidos in Philadelphia and is Vice-Chairman of the Mayor's Commission on Drugs and Alcohol of the City of Philadelphia.

David Metzger

David Metzger, Ph.D., is Associate Professor in the Department of Psychiatry at the University of Pennsylvania and Director of the Opiate/AIDS Research Division of the Center for the Studies of Addiction of the University of Pennsylvania/Veteran's Administration Medical Center. Dr. Metzger is also the principal investigator of the NIH-funded University of Pennsylvania HIV Prevention Trial Unit and a member of the Executive Committee of the University of Pennsylvania Center for AIDS Research.

Roseanne Scotti

Roseanne Scotti, B.A., is a research specialist at the Opiate/AIDS Research Division of the Center for the Studies of Addiction at the University of Pennsylvania/Veteran's Administration Medical Center. She has studied HIV and substance use, including research on young injectors, HIV home testing kits, and HIV seroincidence.