Harm Reduction Journal最新文献

{"title":"Willingness to use a drug checking service for cannabis and cannabis-based products: results from an online survey of people who regularly use cannabis in France.","authors":"Martin Bastien, Salim Mezaache, Cécile Donadille, Laélia Briand Madrid, Maëla Lebrun, Victor Martin, Perrine Roux","doi":"10.1186/s12954-025-01274-0","DOIUrl":"10.1186/s12954-025-01274-0","url":null,"abstract":"<p><strong>Introduction: </strong>As cannabis is illegal in France, there is no regulation of the quality or composition of cannabis products on the illicit market. Although access to drug checking services for people who use drugs (PUD) is possible in several harm reduction (HR) structures for a large number of illicit substances, these structures seldom have the tools needed to adequately analyze organic substances such as cannabis.</p><p><strong>Methods: </strong>We conducted an online survey among people who use cannabis. The survey questionnaire collected data on respondents' socio-demographic characteristics, use of cannabis and other psychoactive substances, and their willingness to use a cannabis drug checking service. We constructed a multivariable logistic regression model to explore factors associated with the latter dimension.</p><p><strong>Results: </strong>Among the 553 participants included in the analyses, 73.4% said they would be willing to use a cannabis checking service. Self-identifying as a woman was negatively associated with the desire to use such a service (ORa [95% CI] = 0.54 [0.35-0.86]). In contrast, having a tertiary education level (ORa [95% CI] = 2.14 [1.45-3.17]) and declaring therapeutic use of cannabis (sometimes/often: ORa [95% CI] = 1.71 [1.09-2.69]; always: ORa [95% CI] = 2.61 [1.25-5.49]) were positively associated factors.</p><p><strong>Conclusions: </strong>Our results highlight the strong willingness of many people who use cannabis in France to control the quality of the cannabis they obtain, particularly persons who use cannabis for therapeutic reasons. The implementation of adequate cannabis checking services in HR structures must take into account the diversity of populations that consume cannabis; in particular, they should be designed in such a way as that more women and persons with a lower level of education will use them.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"126"},"PeriodicalIF":4.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to use syringe services programs in a Northern Midwest American Indian community.","authors":"Molly C Reid, Kristin E Schneider, Allison O'Rourke, Maisie A Conrad, Pamela M Hughes, Melissa L Walls, Sean T Allen","doi":"10.1186/s12954-025-01248-2","DOIUrl":"10.1186/s12954-025-01248-2","url":null,"abstract":"","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"123"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between cannabis use and adherence to COVID-19 public health guidelines: prospective analyses from the French CONSTANCES cohort and SAPRIS survey.","authors":"Rita El Haddad, Emmanuel Wiernik, Sofiane Kab, Marie Zins, Guillaume Airagnes","doi":"10.1186/s12954-025-01278-w","DOIUrl":"10.1186/s12954-025-01278-w","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between the frequency of cannabis use and adherence to COVID-19 public health guidelines among adults in France between April and October 2020.</p><p><strong>Methods: </strong>Data from the CONSTANCES cohort on 39,450 adults participating in the SAPRIS survey were analyzed. The associations between non-adherence to handwashing, mask-wearing and social distancing and cannabis use frequency in 2019 at two periods of time, wave 1 + 2 (confinement) and wave 3 (deconfinement), were examined using binary logistic regression. The models were adjusted for age, sex, education, marital status, accommodation, tobacco use, self-rated health, anxiety and depressive symptoms.</p><p><strong>Results: </strong>Compared to no cannabis use during the past 12 months, cannabis use less than once per month was negatively associated with handwashing at wave 3 (Odds Ratio [95% Confidence Interval]) 1.46 [1.28-1.66], mask-wearing at wave 1 + 2 (1.26 [1.05-1.52]) and at wave 3 (1.60 [1.35-1.89]) and social distancing at wave 1 + 2 (1.32 [1.16-1.50]) and at wave 3 (1.55[1.32-1.83]). Cannabis use once per month or more was negatively associated with mask-wearing at wave 3 (1.41 [1.11-1.80]) and social distancing at wave 1 + 2 (1.27 [1.06-1.52]) and at wave 3 (1.57 [1.25-1.98]).</p><p><strong>Conclusion: </strong>Cannabis use may be associated with less adherence to COVID-19 public health guidelines.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"121"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The implementation of take-home naloxone: Lessons learned from a 3-year take-home naloxone project in Germany.","authors":"Simon Fleißner, Larissa Steimle, Dirk Schäffer, Bernd Werse, Daniel Deimel, Maria Kuban, Heino Stöver","doi":"10.1186/s12954-025-01281-1","DOIUrl":"10.1186/s12954-025-01281-1","url":null,"abstract":"<p><strong>Background: </strong>Take-home naloxone (THN) can prevent deaths related to opioid overdoses. Despite the first THN project in Germany in 1998, the availability of naloxone for people who use opioids (PWUO) is still scarce. We present the results of the German-wide THN-project NALtrain, which aimed to implement THN nationwide. Firstly, we present data collected during NALtrain and secondly, we use this data to critically reflect on the project and thereby draw conclusions that could inform future THN projects.</p><p><strong>Method: </strong>NALtrain was conducted between July 2021 and June 2024. Descriptive statistical analysis of the documentation of 74 train-the-trainer events and following naloxone trainings conducted by the trained staff were carried out.</p><p><strong>Results: </strong>864 staff members from approximately 373 organizations (mainly harm reduction services) participated in 74 train-the-trainer courses. Of the 373 organizations 123 conducted 784 naloxone trainings for PWUO and reached 2,333 PWUO, of whom 1,451 received THN. The goal of training 800 staff members was met, while the goals of reaching 400 organizations and 10,000 PWUO were missed. The implementation of THN is unevenly distributed across the German federal states, especially concentrated in Bavaria. The core learnings are that the prescription-only status of THN leads to extra organizational efforts and hinders the availability of THN for individuals with the highest risk of overdose.</p><p><strong>Conclusion: </strong>Considering the proportion of organizations offering THN, they can still be classified as \"early adopters\". These may serve as role models for the broader majority. Free available THN and centrally coordinated support of implementation including recurring follow-up can be key to a broader availability of THN in Germany. In future initiatives physicians and medical settings should be prioritized.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"120"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HOME protocol for a national online survey of people who inject drugs.","authors":"Winston E Luhur, Cristina L Chin, Jazmine M Li, Grey Marsh, Dan Coello, Aaron Fox, Honoria Guarino, Denis Nash, Viraj V Patel, Czarina N Behrends","doi":"10.1186/s12954-025-01260-6","DOIUrl":"10.1186/s12954-025-01260-6","url":null,"abstract":"<p><p>Most surveys of people who inject drugs (PWID) fail to represent the full population of PWID, because usual recruitment methods do not achieve geographic and sociodemographic diversity. People of color, people residing in rural and/or harm reduction-deprived areas, and people who rarely connect with social services are the least surveyed and understood PWID populations. Online-based recruitment and surveys may better reach these hidden PWID populations than standard venue-based recruitment. As technology use and internet access become more ubiquitous, even for unstably housed populations, research using online-based recruitment and survey techniques are growing in the substance use field. These methods hold promise for obtaining larger and more diverse PWID samples, but there are no standards for using online recruitment and survey administration methods to reach large populations of PWID vulnerable to overdose and other threats. Best practices are needed to maximize data quality, prevent fraudulent responses, and minimize selection biases. The HOME (Harm reduction services Offered through Mail-delivery Expansion) study recruits and enrolls a national, online-recruited, longitudinal cohort of 1233 PWID and follows them for 18 months. Key objectives are to assess prior harm reduction utilization and future uptake of mail-based harm reduction services and retention in these services. We describe our online data collection protocol, including recruitment approaches, detecting fraud, maximizing data quality, and participant retention throughout follow-up. These strategies can inform subsequent large-scale, nationwide efforts that recruit PWID through the internet.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 Suppl 1","pages":"125"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing changes to harm reduction site operations in British Columbia following the implementation of the decriminalization of drugs: Findings from a provincial survey.","authors":"Farihah Ali, Cayley Russell, Justine Law, Sameer Imtiaz, Juls Budau, Rita Shahin, Laura MacKinnon, Dylan Griffith, Sean Patenaude, Jessica Xavier, Jürgen Rehm","doi":"10.1186/s12954-025-01276-y","DOIUrl":"10.1186/s12954-025-01276-y","url":null,"abstract":"<p><strong>Background: </strong>In January 2023, British Columbia (BC), Canada, piloted a three-year decriminalization policy to address the escalating overdose crisis. The policy seeks to reduce stigma and the fear of criminal prosecution, and foster a safer and more supportive environment, encouraging greater utilization of treatment and harm reduction (HR) services among people who use drugs. There are limited data on the operational characteristics of HR sites in BC, which are essential for monitoring how decriminalization may influence service operations and utilization. This study aimed to characterize HR site operations in BC and assess any operational changes following decriminalization.</p><p><strong>Methods: </strong>A cross-sectional, online self-report survey was distributed to HR sites across BC between March and April 2024. The survey was completed by a site representative, and survey questions focused on client demographics and drug use patterns, service uptake and capacity, resource and staffing demands, police activity near sites, and the availability of HR services. Changes pre-and post-decriminalization were analyzed descriptively to identify trends.</p><p><strong>Results: </strong>A total of 33 HR sites completed the survey. Almost a third (30%) of sites reported an increase in client's post-decriminalization, and 18% indicated plans to expand or modify services to meet the increasing demand. However, challenges related to staffing and resources were highlighted, with 45% of sites reporting increased staffing demands post-decriminalization, and 33% noting changes to resource needs, most of which increased. Five sites reported an increase in annual operating budgets. Nearly half (43%) of sites that experienced police activity around their site reported increased police activity post-decriminalization. Moreover, approximately one-fifth (21%) of sites received formal decriminalization training.</p><p><strong>Conclusions: </strong>HR sites have experienced an increase in client engagement post-decriminalization, reporting challenges related to site capacity and funding, and emphasizing the need for additional investments to support and expand HR services. Consideration should be given to needs-based planning and providing decriminalization training to HR staff. Moreover, steps are necessary to address the continued police presence near sites, which may hinder service uptake and perpetuate stigma. Addressing these gaps is critical for improving health system engagement for people who use drugs and achieving the goals of decriminalization.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"122"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I think that that really could benefit a lonely user:\" perceptions of overdose response hotlines among people who use opioids.","authors":"Rachel E Gicquelais, Rachel P Chenoweth, Nora Jacobson, Caitlin Conway, Gina M Bryan","doi":"10.1186/s12954-025-01283-z","DOIUrl":"10.1186/s12954-025-01283-z","url":null,"abstract":"<p><strong>Background: </strong>Overdose response hotlines, such as the SafeSpot and Never Use Alone phone hotlines and Brave smartphone application, are promising tools to reduce fatal overdose risk among people who use drugs (PWUD). These free and confidential services connect callers to a trained operator who monitors them for adverse reactions during and after drug use. We explored PWUD's perceptions of overdose response hotlines.</p><p><strong>Methods: </strong>PWUD receiving substance use treatment in a facility in a Midwestern US city were screened for eligibility using the NIDA-Modified ASSIST questionnaire and invited to enroll if they had a moderate or severe substance involvement score for use of street or prescription opioids. Ten participants completed a 30-45-minute in-depth interview focused on overdose prevention, including perceptions and use of overdose response hotlines, in February 2022. Inductive content analysis was used to describe perspectives on overdose response hotlines.</p><p><strong>Results: </strong>Only 1 of the 10 participants had heard of overdose response hotlines, but most were optimistic about their potential benefits for PWUD. One participant said, \"I believe that if word was out there, people would use it.\" Another stated, \"I would trust it today. I know that there is [sic] people trying to change what's going on in our culture with opiates.\" Participants described several potential barriers to utilization, including distrust, especially in the context of drug-induced paranoia and concerns about being arrested, and the cost of an emergency medical response if an overdose occurred. One participant stated, \"people get paranoid when they're using drugs. And to be like, 'I'm using!' over the phone, that's not too easy.\" Another said, \"If you call 911, the police are coming and if you're using, you're going to jail.\"</p><p><strong>Conclusions: </strong>Overdose response hotlines are acceptable and trustworthy fatal overdose prevention tools. However, several barriers may limit their utilization, including distrust, drug-induced paranoia, and the cost and potential consequences should an overdose occur, including arrest or cost of emergency response. Further study of utilization, acceptability, and policy and practical solutions addressing perceived barriers to utilizing these services are needed.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"124"},"PeriodicalIF":4.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Originated Research to Identify Access Gaps in Over-the-Counter Naloxone Availability in Connecticut Pharmacies.","authors":"Katherine Hill, Peter Canning, Zoey Canning, Cameron Breen, Liz Evans, Mark Jenkins, Mark Nickel, Ken Plourd, Robert Heimer","doi":"10.1186/s12954-025-01268-y","DOIUrl":"10.1186/s12954-025-01268-y","url":null,"abstract":"<p><strong>Background: </strong>Naloxone, a life-saving medication that reverses opioid overdoses, was available in the United States only by prescription until March 2023, when the federal government approved nasal-spray formulations for over the counter sales to expand access. We assessed the availability of naloxone in a sample of pharmacies across the state of Connecticut.</p><p><strong>Methods: </strong>Between September 15 and November 24, 2024, trained community-based volunteers surveyed a convenience sample of pharmacies throughout the state, focusing on naloxone signage, availability, cost, and in-store location. Pharmacies were categorized into three groups: chain pharmacies, pharmacies within grocery stores, and independent pharmacies. Summary statistics for the full sample and the three subgroups were tabulated, and differences between groups were analyzed using Fisher's exact tests.</p><p><strong>Results: </strong>A total of 162 pharmacies across all Connecticut counties were evaluated. While naloxone was available in most pharmacies, it was predominantly kept behind the pharmacy counter (n = 111, 73.5%) or the general checkout counter (n = 46, 30.5%). Fewer than 20% of pharmacies (n = 29) had naloxone easily accessible on an aisle shelf. Pricing was often high (≥ $60), particularly in independent pharmacies (n = 7, 22.6%; p < 0.001). Additionally, fewer than 20% of pharmacies (n = 31) displayed signage related to naloxone availability, and all signage was exclusively in English.</p><p><strong>Conclusions: </strong>Despite widespread availability, naloxone access was restricted by its in-store location, high cost, and inadequate signage. This highlights a notable discrepancy between naloxone availability and accessibility, suggesting a lag in the effective implementation of policy in intended settings.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"119"},"PeriodicalIF":4.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative insights into drug use safety strategies and social support among sexual minority women who inject drugs in Baltimore, Maryland.","authors":"Jennifer L Glick, Leanne Zhang, Aimee Huang, Megan Nguyen, Danielle German","doi":"10.1186/s12954-025-01257-1","DOIUrl":"10.1186/s12954-025-01257-1","url":null,"abstract":"<p><strong>Background: </strong>Sexual minority women (SMW) experience higher rates of substance use relative to heterosexual women in the U.S. but remain an under-studied population. SMW who inject drugs (SMWWID) navigate an unpredictable drug market and may experience complex relationships within their social spheres. We explore cisgender SMWWID's strategies to maintain safety while injecting drugs, and the influence of their social support systems on those strategies.</p><p><strong>Methods: </strong>We conducted N = 16 phone-based, semi-structured, in-depth interviews with SMWWID in Baltimore, Maryland between June-October 2021. The interviews explored participants' sexual orientation and gender identities, social networks and support systems, drug use behaviors and HIV risk, and experiences accessing services. Using an inductive thematic analysis approach, we examined emergent themes related to drug use, social support, safety, and HIV and identified key safety strategies and social support experiences for SMWWID.</p><p><strong>Results: </strong>SMWWID employed various strategies to \"stay safe,\" which they primarily interpreted as ensuring overdose safety (i.e., using drugs in the presence of others, carrying Naloxone, purchasing strategies), and additionally as infectious disease safety (i.e., avoiding syringe sharing, using sterile syringes) and avoiding threats of violence (i.e., maintaining situational awareness while using drugs). Romantic or sexual partners, family and friends, and the wider community were sources of social support for overdose safety, and family and friends also provided material support (e.g., financial, housing). Syringe sharing with romantic partners and threats of violence from people in the community detracted from SMWWID's safety.</p><p><strong>Conclusion: </strong>SMWWID in this sample reported strong safety prioritization while using drugs, often facilitated by their social support systems. Harm reduction interventions that consider SMWWID's relationships, including those that aim to improve social connectedness, may better meet the needs of SMWWID, thereby enhancing safety.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"118"},"PeriodicalIF":4.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug use and sexual behaviors among women who inject drugs and use a syringe services program; Miami, Florida.","authors":"Belén Hervera, Teresa A Chueng, Joy Scheidell, Katrina Ciraldo, Sabrina Soto Sugar, Marina Plesons, Hansel E Tookes, David P Serota, Raymond R Balise, Noby Nakamuro, Shelby Meaders, David W Forrest, Tyler S Bartholomew","doi":"10.1186/s12954-025-01266-0","DOIUrl":"10.1186/s12954-025-01266-0","url":null,"abstract":"<p><strong>Background: </strong>Women who inject drugs (WWID) face disproportionately higher risks of infectious diseases, reproductive health challenges, and gendered social and structural vulnerabilities compared to men. Despite these elevated risks, most harm reduction programs do not tailor their services to meet the needs of WWID. In Florida, where syringe service programs are relatively new and implemented at the county-level, access remains limited. These gaps are especially pronounced for WWID, who face additional barriers due to restrictive reproductive policies and limited access to gender-responsive care. This study examined gender-related risks among people who inject drugs (PWID) accessing a SSP in Miami, Florida to inform harm reduction service delivery and intervention needs.</p><p><strong>Methods: </strong>This study analyzed enrollment data from the first legal SSP in Florida collected from its December 2016 inception through July 2022 (N = 1660). In bivariate analyses, we used chi-square tests to describe differences in sociodemographic, injection drug use (IDU) and sexual behaviors, and infectious disease prevalence between men and women. We used multivariable logistic regression models to estimate associations between gender and IDU behaviors, sexual behaviors, and HIV/HCV prevalence, adjusting for age, race/ethnicity, housing status, and enrollment year.</p><p><strong>Results: </strong>Our sample included 1660 participants (26% women). Compared to men, WWID had significantly higher odds of sharing syringes (adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI], 1.23-2.10), injecting over five times per day (aOR = 1.33, CI 95%, 1.05-1.70), injecting opioids only (aOR = 1.79, 95% CI 1.35-2.38), and opioid/stimulant co-injection versus stimulant-only injection use (aOR = 1.46, CI 95%, 1.03-2.6). WWID also had higher odds of engaging in recent sexual activity (aOR = 1.75, 95% CI, 1.25-2.45), exchanging sex for money/resources (aOR = 6.60, 95% CI, 4.12-10.57), and testing reactive for HCV antibody at time of enrollment (aOR = 1.41, 95% CI, 1.10-1.80).</p><p><strong>Conclusion: </strong>Drawing on real-world programmatic data from routine SSP intake, this study highlights the. elevated injection and sexual health risks faced by WWID accessing a SSP. Findings support the need for gender-responsive harm reduction strategies, including bundled, trauma-informed services that integrate safer injection supplies, overdose prevention, reproductive and sexual healthcare, and peer-led education initiatives that also address the social and structural determinants of health-such as trauma, poverty, housing instability, stigma, criminalization, and relational dynamics. These findings directly informed the development of a women-centered harm reduction clinic at the IDEA Miami SSP. This model may inform responsive service design in similar settings.</p>","PeriodicalId":12922,"journal":{"name":"Harm Reduction Journal","volume":"22 1","pages":"117"},"PeriodicalIF":4.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"社会学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}