Special thanks to PhD student Bree Casper who conducted 20 client interviews and assisted with the writing of the results.
In order to understand the broader impact the SSP is having on individuals and communities, we collected qualitative data through individual interviews with participants and program volunteers.
While the data is currently being analyzed, we (Romero-Daza, Rigg) present some of the preliminary findings below.
SSP Participant Interviews:
From November 19th, 2021 to January 7th, 2022 we conducted 20 semi-structured interviews with participants of IDEA Exchange Tampa across two exchange locations (University Mall and Ybor City).
Of participants interviewed, 45% identified as male, and 55% identified as female. Participants racial/ethnic breakdown included, 75% of participants who identified as white, 10% of participants who identified as Black, and 15% of participants identified as Hispanic.
Semi-structured interviews lasted between 10 and 30 minutes and engaged participants on the following topics: history of use and how they used to get safe injection supplies, experiences since joining the exchange program, and critiques of the program.
When referring to their past use, participants often noted that they got needles from “mom & pop” pharmacies (local, non-chain pharmacies who are willing to sell to people who inject), or by buying them from dealers and friends at an upcharge. Few participants were able to purchase needles and supplies online (through websites like Amazon). All participants learned about the exchange through word-of-mouth. When asked how the exchange has changed their use, most participants noted that the exchange made their use safer and they benefited from access to safe injection supplies (in addition to clean needles). As some participants noted in their interviews:
“It definitely made it [injecting drugs] safer… there has been lots of time where I had to reuse needles. You know, recently before I came here, I actually had one [needle] break off in my arm because it was so old and I just had to keep reusing it.”
“Before I would never use an alcohol swab or cotton. I would just kind of wing it and hope I don’t die. And the Narcan also just really helps. Narcan was always so hard to get. Someone would OD. You guys have probably saved so many people with Narcan.”
Many participants told deeply emotional stories about how the Narcan they got at the exchange saved themselves or their friends.
Participants have self-reported 1,350 reported overdose reversals to date. Referral services offered at the exchange (such as MAT treatment and HCV/HIV treatment) were noted and appreciated by participants, but not many had used the referrals offered to them at the time of the interview.
When asked if there was anything we could do better, participants noted that the only shortfall was the sometimes-inconsistent inventory experienced in the last three months of the year.
“The inventory…the first time I came you guys had a better variety.”
Finally, one of the standout comments from almost all participants was the community and lack of judgment they felt at the exchange.
“Y’all are discreet. You don’t make us feel like we are less than or any different then you guys.”
“You guys are very helpful, you offer needles, but you also offer ways to get in rehab…you guys are not judgmental. You guys are very welcoming.”
“You guys are there for us in a way that you don’t even understand you are… and that to me is the definition of selfless and admirable, and it only promotes positive public health effects, and I can’t see a negative to any of that.”
SSP Volunteer Interviews
In addition, we conducted semi-structured interviews with five USF students who have volunteered their time to the SSP since its inception. The participants were all second-year medical students in their mid-twenties and included four who identified as female and one who identified as male. The responses from the volunteers echoed some of the themes that emerged in participant interviews, including the clear benefits of providing clean needles and other needed materials, and of offering Narcan to help reduce the number of potentially fatal overdoses.
Likewise, all the volunteers commented on the respectful and caring service provided by the staff that run the program.
“You can definitely see that when people come to the exchange they are treated like equals, they are never made to feel like they are less than anyone else just because they use drugs. You can see that they [staff] really care and are truly committed to the cause.”
Volunteers also highlighted the benefits their involvement in the SSP operations offers them as future medical doctors.
Notably, they mentioned that volunteering with the program has allowed them to get a better understanding of the complex nature of addiction and to put a “human face” to the statistics they often read about in their classes.
When asked about ways to improve the program, three of the volunteers mentioned the need to disseminate information about the services through various channels, including social media and through ads in utilitarian spots such as benches in public bus stops.
Table 1. Descriptive Statistics among IDEA Tampa Syringe Service Program Clients
|Characteristic||IDEA Tampa SSP (N=546)|
|Age (mean, SD)||40.9 (10.2)|
|Black/African American||43 (8.1)|
|Native American||8 (1.5)|
|<8th grade||20 (3.7)|
|Some High School (no diploma)||68 (12.6)|
|High School/GED||234 (43.4)|
|Some College||134 (24.9)|
|College Degree||57 (10.6)|
|Advanced Degree||4 (0.7)|
|Vocational Training||22 (4.1)|
|Experiencing unstable housing||229 (42.5)|
|Stably housed||310 (57.5)|
|Substance Use (non-injection)|
|Pain killers||19 (3.5)|
|Prescription Opioids||33 (6.0)|
|Substance Use (injection)|
|Prescription Opioids||49 (9.0)|
|Speedball (heroin/cocaine)||24 (4.4)|
Table 2: Program-specific Metrics
|Number of individual participants served||546|
|Number of used needles and syringes received||114,821|
|Number of unused needles and syringes distributed||113,991|
|Syringe Return Ratio (>1 = more syringes in then out)||1.01|
|Number of persons receiving HIV testing||187|
|Percent testing HIV reactive||2.7%|
|Number of persons receiving HCV testing||178|
|Percent testing HCV reactive||44.4%|
|Number of naloxone doses distributed||1243|
|Number of overdose reversals performed||1108|