Date of Publication

Spring 1-17-2018


Introduction and Aims. Vermont CARES is a nonprofit HIV prevention and advocacy organization which provides a needle exchange program for intravenous drug users. Services are focused on education, prevention, testing, and harm reduction. The Syringe Support Program (SSP) offers clients clean syringes to reduce intravenous transmission of disease.

Although SSP are proven avenues for harm reduction, barriers prevent users from utilizing services. Clients are limited by social, economic, and personal obstacles de- scribed in similar populations across the country. This project seeks to identify the barriers Vermont CARES clients face in accessing the SSP, determine needs, and evaluate interest in additional services.

Methods. Our team and Vermont CARES staff held a focus group with St. Johnsbury clients to discuss services and barriers. A 39 question paper survey was distributed to three Vermont CARES sites during October, 2017 by Vermont CARES. Participation was voluntary and uncompensated. Sixty-three clients completed the survey.

Results and Discussion. Of the 63 respondents, 61.9% stated that lack of ade- quate income contributed most to their inability to meet basic needs. These same clients faced the most barriers to access with economic hardship precipitated by sub- stance abuse, disability, and family commitments. In assessing additional services, clients sought food pantries, hygiene kits, and dental clinics. 56.4% of respondents would use safe injection facilities if provided. Those without income to meet basic needs expressed most interest in safe injection facilities (p=0.022). With barriers recognized, our future aim is to track efficacy of new services in impacting care and quality of life.


Jerry Larrabee

UVM Larner College of Medicine

Peter Jacobsen

Vermont CARES


HIV, Immunization and Infectious Diseases

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Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License

Barriers Encountered by Syringe Exchange Clients in Vermont