Program Adaptations to Provide Harm Reduction Services During the COVID-19 Pandemic: A Qualitative Study of Syringe Services Programs in the U.S.

Frost, Madeline C.; Sweek, Elsa W.; Austin, Elizabeth J.; Corcorran, Maria A.; Juarez, Alexa M.; Frank, Noah D.; Prohaska, Stephanie M.; LaKosky, Paul A.; Asher, Alice K.; Broz, Dita; Jarlais, Don C. Des; Williams, Emily C.; Glick, Sara N.

Syringe services programs (SSPs) are essential to preventing injection drug use-related infections and overdose death among people who use drugs (PWUD). The novel coronavirus (COVID-19) pandemic initially impeded SSPs’ operations. To effectively support these programs, information is needed regarding SSPs’ experiences adapting their services and the challenges posed by COVID-19. We conducted qualitative interviews with leadership and staff from a sample of 31 U.S. SSPs. Respondents discussed urgent concerns including reduced reach of services, suspended HIV/hepatitis C testing, high COVID-19 risk among PWUD, and negative impacts of isolation on overdose and mental health. They also noted opportunities to improve future services for PWUD, including shifting to evidence-based distribution practices and maintaining regulatory changes that increased access to opioid use disorder medications post-pandemic. Findings can inform efforts to support SSPs in restoring and expanding services, and provide insight into SSPs’ role in engaging PWUD during the COVID-19 response and future emergencies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10461-021-03332-7.