Browsing by Author "Frank, David"

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    I Don't Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois
    (MDPI, 2023) Walters, Suzan M.; Felsher, Marisa; Frank, David; Jaiswal, Jessica; Townsend, Tarlise; Muncan, Brandon; Bennett, Alex S.; Friedman, Samuel R.; Jenkins, Wiley; Pho, Mai T.; Fletcher, Scott; Ompad, Danielle C.; New York University; Jefferson University; University of Alabama Tuscaloosa; State University of New York (SUNY) Stony Brook; Stony Brook University Hospital; Southern Illinois University; University of Chicago
    Background: Overdose is a leading cause of morbidity and mortality among people who inject drugs. Illicitly manufactured fentanyl is now a major driver of opioid overdose deaths. Methods: Semi-structured interviews were conducted with 23 participants (19 persons who inject drugs and 4 service providers) from rural southern Illinois. Data were analyzed using constant comparison and theoretical sampling methods. Results: Participants were concerned about the growing presence of fentanyl in both opioids and stimulants, and many disclosed overdose experiences. Strategies participants reported using to lower overdose risk included purchasing drugs from trusted sellers and modifying drug use practices by partially injecting and/or changing the route of transmission. Approximately half of persons who inject drugs sampled had heard of fentanyl test strips, however fentanyl test strip use was low. To reverse overdoses, participants reported using cold water baths. Use of naloxone to reverse overdose was low. Barriers to naloxone access and use included fear of arrest and opioid withdrawal. Conclusions: People who inject drugs understood fentanyl to be a potential contaminant in their drug supply and actively engaged in harm reduction techniques to try to prevent overdose. Interventions to increase harm reduction education and information about and access to fentanyl test strips and naloxone would be beneficial.
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    PrEP Care Continuum Engagement Among Persons Who Inject Drugs: Rural and Urban Differences in Stigma and Social Infrastructure
    (Springer, 2022) Walters, Suzan M.; Frank, David; Van Ham, Brent; Jaiswal, Jessica; Muncan, Brandon; Earnshaw, Valerie; Schneider, John; Friedman, Samuel R.; Ompad, Danielle C.; New York University; Southern Illinois University; University of Alabama Tuscaloosa; State University of New York (SUNY) Stony Brook; Stony Brook University Hospital; University of Delaware; University of Chicago
    Pre-exposure prophylaxis (PrEP) is a medication that prevents HIV acquisition, yet PrEP uptake has been low among people who inject drugs. Stigma has been identified as a fundamental driver of population health and may be a significant barrier to PrEP care engagement among PWID. However, there has been limited research on how stigma operates in rural and urban settings in relation to PrEP. Using in-depth semi-structured qualitative interviews (n = 57) we explore PrEP continuum engagement among people actively injecting drugs in rural and urban settings. Urban participants had more awareness and knowledge. Willingness to use PrEP was similar in both settings. However, no participant was currently using PrEP. Stigmas against drug use, HIV, and sexualities were identified as barriers to PrEP uptake, particularly in the rural setting. Syringe service programs in the urban setting were highlighted as a welcoming space where PWID could socialize and therefore mitigate stigma and foster information sharing.