Project summary
While syringe service programs remain a leading method of delivering harm reduction supplies in the United
States, they remain underutilized by the most vulnerable populations of people who use drugs (PWUD). To
reduce substance use related harms, we need to provide a suite of harm reduction service delivery
approaches that address the needs of a diverse and evolving population of PWUD. This proposed project will
examine an innovative approach to reducing infectious disease transmission and fatal overdose in an
understudied Western region. Used internationally for decades, harm reduction vending machines (HRVMs)
were implemented in Nevada in 2017 and contain supplies like syringe kits, naloxone, and fentanyl test strips.
It is unknown if HRVMs are an acceptable and feasible mode of service delivery and if they address the unmet
needs of underserved PWUD in the US. This study will explore how, why, and who uses (and doesn't use) this
novel method of service delivery. We propose a theory driven exploratory mixed-methods study to address the
following aims:
1. Determine who HRVMs are reaching by 1) estimating awareness, intention to use, and prevalence of
HRVM use, and 2) describing the associations with demographics, behavioral characteristics, social
and environmental factors, and perceived barriers and facilitators.
2. Identify what factors influence HRVM use through a Rapid Ethnographic Assessment consisting of field
site observations, ethnographic mapping, and qualitative interviews.
Findings from this proposed research will tell us who is using HRVMs, who is not using HRVMs, what
motivates and restricts their use, and areas for improvement to increase utilization. This information is vitally
important to policy makers, public health practitioners, funders, and community-based organizations where
resources are limited, and data-driven decisions produce better outcomes. This proposal addresses the NIDA
2022-2026 strategic plan goal to accelerate the science of harm reduction and will be directly and immediately
relevant to informing national drug control strategy.
