Date of Conferral

2023

Degree

Ph.D.

School

Public Health

Advisor

Michael Schwab

Abstract

In rural areas of the United States, people who inject drugs (PWID) experience an array of obstacles to accessing adequate healthcare. Locations with high rates of drug use normally offer more healthcare options, including needle exchange programs but, in some communities, there is resistance to providing this kind of care. This increases mortality, morbidity, cost, and adds to the stigma experienced by this vulnerable group. The experiences of people with substance dependency, including PWID, has been widely explored throughout studies that reflect a need for increased support. However, the perspectives of the community, especially in rural areas, though equally important, have been largely ignored, even though they have the potential to reduce obstacles to care, and could unlock resources to reduce disparities in mortality and morbidity. In this basic qualitative study, the perceptions of eight community members currently located in communities lacking syringe services were explored using semistructured interviews to uncover factors that influence community support for PWID and syringe services. The socio-ecological model served as the theoretical framework. Quirkos was used to code the data. All participants stated that drug use is an issue for the community and acknowledged that some form of intervention needs to occur. However, major challenges to gaining community support were identified, for example, fears of a negative effect on property values. Factors that influence community support included the proper location of services and the need for community inclusion in the process of determining access to syringe exchange and other wellness options. As the drug epidemic continues to rise in rural locations, these results could lead to wider acceptance and implementation of syringe exchange programs, and this would represent positive social change.

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