An Integrated Supervised Injecting Program Within a Care Facility for HIV-Positive Individuals: A Qualitative Evaluation

Little study has been devoted to the potential role that supervised injecting programs could play in increasing access to prevention and care services for injection drug users (IDUs) who are HIV-positive.

The authors of the current report conducted 22 semi-structured interviews with HIV-positive IDUs regarding a supervised injection program integrated in the Dr. Peter Center, an HIV-focused care facility in Vancouver, British Columbia. The researchers also interviewed seven staff members who supervise injections at the center. All the interviews were audio-recorded and transcribed verbatim, and a thematic analysis was conducted.

Reports from participants as well as staff indicated that the integrated supervised injection program affected IDUs' access to care by fostering more open and trusting relationships with staff, facilitating engagement in safer injection education, and improving management of infections related to injecting. Participants and staff alike felt the program facilitated care delivery by mediating overdose risks, reducing the need to punitively manage drug use at the center, and lowering the risk of encountering used syringes at the facility.

"For some participants, however, feelings of shame and fear of judgment in relation to their drug use limited initial uptake of the program," the authors concluded. "Our findings identify mechanisms through which integrated supervised injection programs may serve to better facilitate access and delivery of comprehensive care for HIV-positive IDUs and highlight the benefits of addressing HIV-positive IDUs' drug use in the context of comprehensive models of health care."

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