Syringe sharing reduced among PWID with improved access to methadone providers
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Key takeaways:
- Methadone provider clinics are often unavailable to PWID because of distance and frequency of visits.
- Increasing providers reduced syringe sharing in areas with a large amount of PWID, but access was reduced in suburban areas.
BOSTON — There is a reduction in syringe sharing when methadone providers are spread out near areas with the greatest density of people who inject drugs, according to research presented at The Liver Meeting.
Researchers in Chicago established a baseline scenario of spatial access using locations of existing methadone providers in the metropolitan area. The locations of providers were then spatially redistributed based on the densities of the general population and the population of people who inject drugs (PWID) per zip code.
Different methadone access assumptions were defined as short, medium and long travel distance preferences combined with urban/suburban travel distance preference. Researchers also defined a decision regret score to represent the difference in syringe-sharing reduction for the four provider distribution areas relative to the distribution area with the largest reduction in syringe sharing.
The ideal outcome was a decision regret of zero representing reduced syringe sharing, according to the abstract.
Results showed that simulation scenarios, which spanned reasonable access assumptions from least optimistic to most optimistic, highlighted variation and heterogeneity in syringe sharing among PWID, as well as drug-use behaviors and co-injection risks.
It was noted in the presentation that individual PWID behaviors can be difficult to observe. Therefore, instead of attempting to quantify optimal interventions to reduce syringe sharing, further research should examine interventions that perform well over a wide range of empirical measurements and address decision-making uncertainties.
While it was found that distributing providers near areas with greatest density of PWID is best for reducing syringe sharing when there is a low travel distance preference, this would decrease access to providers in suburban areas and regions with fewer transit options.
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Tatara E, et al. Optimizing methadone provider locations for reducing syringe-sharing behavior and HCV transmission risk among persons who inject drugs in metropolitan Chicago, IL. Presented at: The Liver Meeting; Nov. 10-14, 2023; Boston (hybrid meeting).
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