Barriers to accessing sterile injecting equipment for people who inject drugs: An integrative review

Background The global prevalence of hepatitis C virus infection is estimated to be 71 million, with an estimated 6.1 million of those having recently injected drugs. The recognised measures to prevent hepatitis C transmission in people who inject drugs are needle and syringe programmes. As people who inject drugs are at considerable risk of hepatitis C transmission, understanding the barriers they encounter when accessing needle and syringe programmes is important to support the hepatitis C elimination goal. Objective This integrative review aimed to synthesise research exploring the barriers to accessing sterile injecting equipment faced by people who inject drugs. Methods An integrative review was conducted guided by the PRISMA 2020 checklist, based on a systematic literature search using the following databases: CINAHL, MEDLINE, PsycINFO, Embase, psychology & behavioural sciences collection, and Emcare, as well as Google Scholar. Results The search returned seven studies which met the criteria, and four key themes were identified: stigma; experienced and internalised, purchase experience, practical issues, and fear of negative consequences. Participants reported barriers such as the location of the services, and concerns around confidentiality when accessing services. In addition to this, the fear of arrest and the involvement of social services proved to discourage access to these services. Conclusions People who inject drugs face many challenges when accessing sterile injecting equipment, such as stigma, purchase experience, practical issues and fears and concerns. To support the World Health Organisation Hepatitis C virus elimination plan, these barriers must be tackled to maximise the provision and reduce hepatitis C transmission and reinfection rates. Since the level of research on this topic is limited, further studies are strongly needed. No patient or public contribution Patient and public involvement were not used for this review.