The HIV Epidemic: Is Increased Access to Syringe Services the Answer?

Syringe services programs (SSPs) aim to reduce the spread of HIV among people who inject drugs (PWID), as use of shared needles puts them at high risk of contracting or transmitting the infection. Although SSPs have increased over the years, a recent CDC report in the Morbidity and Mortality Weekly Report concludes that too few PWID use sterile needles.¹

Data from the National HIV Surveillance System analyzed HIV diagnosis trends among PWID from 2008 to 2014 from all 50 states and the District of Columbia. Interviews conducted with PWID from 2005 to 2015 helped determine risk behaviors and the use of prevention services.

The data suggested that HIV diagnoses dropped by almost half between 2008 and 2014 among PWID in the United States, which can be largely attributed to SSPs and other prevention platforms. HIV diagnoses dropped nearly 50% in Hispanic PWID, and 60% in African American PWID.

“It is encouraging to see prevention efforts paying off in African American and Latino communities,” Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention, said in a press release. “We must now take concrete steps that build upon and accelerate that progress.”

Although 54% of PWID in 2015 reported using SSPs compared to 36% in 2005, the report stated that 33% of PWID admitted to using a shared needle in the past year compared to 36% in 2005.

Instances of needle sharing among white PWID remained high, with only a slight decrease, and the percentage of white PWID who received syringes from sterile sources remained unchanged.

CDC officials cited concern that spikes in prescription opioid and heroin abuse could stall or reverse progress in HIV prevention, presenting new opportunities for HIV outbreaks. However, more access to SSPs can mitigate HIV risks and help reduce HIV diagnoses.

Health care providers can provide screening and HIV risk reduction counseling to PWID, appropriate vaccinations, continual testing and treatment, sterile syringe prescriptions or SSP referrals, access to naloxone, and PrEP prescriptions. For all PWID, access to comprehensive prevention programs is essential for successful HIV treatment and prevention, the researchers concluded.

Reference

• Weiner C, Hess KL, Hall HI, et al. Vital Signs: Trends in HIV Diagnoses, Risk Behaviors, and Prevention Among Persons Who Inject Drugs — United States. MMWR Morbidity and Mortality Weekly Report. 2016;65;1336 — 1342. doi; http://dx.doi.org/10.15585/mmwr.mm6547e1