Disparities Found in Prevention Activities in Rural and Urban Communities

The REACH Lab’s director of data analysis, Patrick Habecker, and principle investigator, Kirk Dombrowski, worked with other researchers to publish a paper in the International Journal of Drug Policy’s May 2017 volume. This paper found that people who inject drugs in urban settings were significantly more likely to utilize prevention programs and activities that aid in less risky injection behavior.

Injection drug use and its associated blood-borne infections has become a rapidly increasing problem in rural areas of the US recently. Syringe exchange programs have been shown to be effective for reducing transmission of blood borne infections, however access to these prevention efforts may be limited in rural areas.

This paper utilizes two separate community samples of people who inject drugs (PWID) in Puerto Rico to achieve the following research objectives: (1) compare rural and urban access to syringe exchange programs, free sterile syringes and other HIV/HCV prevention activities, and (2) examine whether utilization of prevention activities is associated with lower injection risk behaviors. Two samples were recruited with RDS (n = 315 rural sample; n = 512 urban sample) and included adults aged 18  years and older who have injected drugs within the past month.

Researchers found that Urban PWID were significantly more likely to have utilized syringe exchange programs, received free sterile needles, received free works, and to have talked about HIV prevention with an outreach worker during the past year than PWID residing in rural areas. Individuals who accessed these prevention activities were significantly less likely to exhibit risky injection behavior.

Policy implications call for increasing access to prevention services in rural areas to reduce disease transmission.

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