We assessed correlates (sociodemographic, substance use, and injection-related factors) of obtaining syringes from syringe services programs (SSPs) and/or pharmacies among persons who inject drugs (PWID) in the United States (US) in 2022 to identify gaps in use among subpopulations of PWID. The 2022 National HIV Behavioral Surveillance conducted biobehavioral surveys among PWID using respondent-driven sampling. Using log-linked Poisson regression models, we examined past-year characteristics associated with obtaining syringes from (1) SSPs; (2) pharmacies; or (3) SSPs and pharmacies in the last 12 months. Of 7095 participants, 47% used SSPs (but not pharmacies), 14% obtained syringes from pharmacies (but not SSPs), and 9% used both SSPs and pharmacies in the past 12 months. SSP use was associated with HIV or hepatitis C (HCV)-related outcomes, including PrEP awareness (aPR 1.14, 95% CI 1.07–1.21), HIV behavioral intervention participation (aPR 1.22, 95% CI 1.13–1.31), and having a previous HCV diagnosis (aPR 1.19, 95% CI 1.12–1.26). Incarceration (aPR 1.18, 95% CI 1.06–1.32) and residing in the Midwest vs. the Northeast (aPR 3.52, 95% CI 2.19–5.65) were associated with obtaining syringes from pharmacies. Black/African American PWID were less likely to have used SSPs or pharmacies to obtain syringes compared with White PWID. Participation in several intervention activities aimed at reducing injection-related, adverse health outcomes was associated with SSP use. Obtaining syringes from pharmacies (but not SSPs) was more common among PWID who had been recently incarcerated. Racial/ethnic disparities in use of SSPs and pharmacies persist; HIV and HCV prevention efforts should focus on increasing participation in SSPs and pharmacies among racial/ethnic minority PWID populations.
Correlates of syringe acquisition at syringe services program and pharmacies among persons who inject drugs: National HIV Behavioral Surveillance, United States, 2022
Journal of Urban Health [Epub 2026 Jul 21]. doi: 10.1007/s11524-026-01118-7. PMCID: PMC13404119.