Social spaces and HIV outcomes for injecting drug users
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Background Since 1997, the United States Public Health Service has recommended that injection drug users who cannot or will not stop injecting obtain and use a new needle for every injection. San Francisco has approximately 5,000 injecting drug users aged under 30. Approximately 6% already have HIV, and 50% have hepatitis C (HCV). Most young injectors in San Francisco acquire at least some of their needle needs through City-funded needle exchanges, however many still share and re-use needles, suggesting that there are other barriers to getting and using enough needles to prevent the transmission of HIV and HCV. The existing research on barriers to the use of needle exchange has identified both operational issues, such as inconvenient or insufficient locations of operation, and structural issues, such as fear of identification or harassment by police, as potential barriers. However, there is little or no research on the ways an individual's exposure to the criminal justice system might impact on their willingness or ability to utilize HIV prevention programs such as needle exchange. Likewise, there is also a long tradition of locating HIV prevention services in the communities in which high-risk populations are assumed to live, however young injectors are usually highly mobile and often homeless, making “neighborhood of residence” a meaningless idea. Young injectors move through (or avoid) multiple neighborhoods in the course of their day; understanding how and why they might see these areas as safe or unsafe; as easy to get to or as 'far away'; as places to visit briefly or as places to spend most of their day in, and understanding how the way they see these areas might change depending on their current legal status, are crucial to understanding how and why they utilize, or under-utilize, or fail to utilize, core HIV prevention interventions such as needle exchange. Goals The two goals of this project are to statistically look at the relationships between the legal status of young injectors in San Francisco and their ability to get and use one needle for every injection; and to interview them about the ways they feel about the neighborhoods or areas they move through during the day as it relates to the location of HIV prevention programs such as needle exchange. Relevance to HIV/AIDS Acquisition and use of sufficient needles to meet the US Public Health Service standard of one needle per injection is the single most effective HIV prevention intervention for those who cannot or will not stop injecting drugs. California has led the US in funding needle exchanges; understanding the barriers to the appropriate use of these programs is critical to ensuring the effectiveness of these programs for preventing the spread of HIV and other diseases in California. Methods This study builds on an existing study of young injectors being done by the University of California, San Francisco. By asking some extra questions of everyone who participates in that study, and by doing extended interviews with 30-40 of the participants in the study, this project will examine how the ways young injectors relate to the legal system and to the neighborhoods they live in might affect the ways they use or fail to use a critical HIV prevention intervention.