Abstract
“We’re Real Harm Reduction.not Performative Harm Reduction”: Exploring How Organizational Values Shape the Delivery of Health Services Within Syringe Services Programs
Drug and alcohol dependence, v 267, pp 117-117
01 Feb 2025
Abstract
Aim: To explore how organizational values influence health service prioritization within syringe services programs (SSPs).
Methods: We purposively sampled SSPs offering HIV testing across the U.S. Representative(s) familiar with their organization’s health-related services (frontline and/or leaders) completed a brief organizational survey and a semi-structured qualitative interview exploring which health services are provided and how. We reviewed structured fieldnotes and transcripts to explore “organizational values,” an emerging theme related to service prioritization.
Results: While all 23 SSPs that were interviewed distributed naloxone and offered HIV testing (either onsite or through referral), fewer provided pre-exposure prophylaxis (n=10), HIV treatment (n=8), MOUD (n=7), or wound care (n=12). Aligning service provision with harm reduction principles, like “respect” and autonomy, was integral. Rather than steering participants towards particular services, most programs emphasized the importance of building rapport through intentional engagement (e.g., open conversations, equity-based outreach strategies, respect of privacy) and “meeting people where they’re at.” For example, few SSPs routinely offered participants HIV testing, and instead encouraged participants to self-identify the services they need. Some SSPs also highlighted their ability to provide nonjudgmental care and were thus more effectively positioned than other healthcare organizations to offer life-saving services (e.g., naloxone, MOUD). Even in the context of discussing tangible barriers such as funding and organizational capacity, value-driven service delivery still predominated decision-making for most SSPs.
Conclusions: SSPs originated as a response to HIV but many have shifted priorities to address changing contexts (e.g., fentanyl and xylazine contaminated drug supplies) and the myriad of health threats faced by participants (e.g., climbing overdose and hepatitis rates). Given the salience of organizational values in shaping service provision at SSPs, future research is needed to delineate and align other implementation considerations with these values in order to bring SSP-based services to scale.
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Details
- Title
- “We’re Real Harm Reduction.not Performative Harm Reduction”: Exploring How Organizational Values Shape the Delivery of Health Services Within Syringe Services Programs
- Creators
- Rose Laurano - Drexel UniversityElana Forman - Dornsife School of Public Health, Drexel UniversityAngela R. Bazzi - University of California, San DiegoWilliam H. Eger - University of California, San DiegoJessica Smith - RTI InternationalShelby Huffaker - University of California, San DiegoChristopher F. Akiba - RTI InternationalSheila V. Patel - RTI InternationalBarrot H. Lambdin - RTI InternationalAlexis M. Roth - Drexel University
- Publication Details
- Drug and alcohol dependence, v 267, pp 117-117
- Conference
- 2024 Annual Meeting of the College on Problems of Drug Dependence (Montreal, Canada, 15 Jun 2024–19 Jun 2024)
- Publisher
- Elsevier
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:001433433000132
- Other Identifier
- 991022027538104721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychiatry
- Substance Abuse