While rates of opiate addiction and HIV infections are on the rise in rural areas, those areas have a severe lack of prevention services, says a study by the Centers for Disease Control and Prevention. In March 2014, the U.S. had 204 syringe service programs (SSPs). Of the 153 that participated in the CDC survey, only 20 percent—30 of 153—were located in rural areas, and just one was in the South. Of the rest, 18 were in the West, six in the Midwest, four in the Northeast and one in Puerto Rico.
The report found that 2,654,551 syringes were exchanged in rural areas, compared to more than 31 million in urban areas. Rural programs had an average budget of around $26,000, compared to $184,000 for urban ones, with urban areas accounting for 83 percent of all budgeted money for programs.
Most SSPs offered HIV counseling and testing (87 percent rural, 90 percent urban) and hepatitis C (HCV) testing (67 percent rural, 78 percent urban). Few SSPs reported having referral tracking systems for HCV-related care and treatment (33 percent rural, 44 percent urban). Rural SSPs were less likely to provide naloxone for reversing opioid overdoses, with 37 percent offering the service, compared to 61 percent of urban programs.
Don Des Jarlais, Professor of Psychiatry and Preventive Medicine at
Icahn School of Medicine at Mount Sinai and lead author of the study, wrote: "Syringe service programs have been very effective in reducing HIV transmission in the U.S. and throughout the world. Our data show that rural and suburban SSPs face some special challenges in recruiting clients, funding and staffing but that these programs can provide the needed services when they are implemented. The biggest problem is simply that we do not have enough of them in rural and suburban areas. State and local governments can save lives by extending these programs."
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