Syringe service programs (SSPs) providing syringe exchange and/or other health services are less available to persons who inject drugs (PWID) in suburban and rural areas than in cities. State and local governments should extend SSPs to PWID in rural and suburban areas. Many suburban and rural areas in the US are have been experiencing dramatic increases in injection drug use, accompanied by outbreaks of HIV and hepatitis C virus (HCV) infections and opiate overdose deaths.

SSPs, including syringe exchange, have proven highly effective in reducing HIV and HCV infection in areas where they have been properly implemented. Many SSPs also distribute naloxone to reverse opiate overdoses. We conducted a national survey of syringe service programs (SSPs) in the US and compared SSPs operating in urban, suburban and rural areas. There were substantially fewer SSPs in rural and suburban than in urban areas. Syringe exchange, naloxone distribution and other needed health services should be expanded to persons who inject drugs in suburban and rural areas.

Article: Syringe Service Programs for Persons Who Inject Drugs in Urban, Suburban, and Rural Areas - United States, 2013, Don C. Des Jarlais, PhD; Ann Nugent; Alisa Solberg, MPA; Jonathan Feelemyer, MS; Jonathan Mermin, MD; Deborah Holtzman, PhD, Morbidity and Mortality Weekly Report, published 11 December 2015.