M od u l e 2 : O p e r at i o n a l Iss u e s Whether the SAP operates on its own or is coupled with additional program services, it is essential to keep the syringe access component “low threshold” to ensure that participation is maximized. Low threshold means that to the greatest extent possible, any barriers to receiving services are kept to a minimum. Barriers can refer to: • Eligibility criteria for participation • Registration and syringe transaction procedures and requirements (such as ID) • Required participation in other programs or services • The level of personal information collected during any interaction (that could make people uncomfortable or reluctant to engage) • Hours of operation • Location • Literacy requirements • Waiting time to get/dispose of syringes • Language barriers • Any other program elements that may make accessing services more cumbersome for the participant. Ultimately, syringe transactions that are quick, easy and discreet are likely to meet the needs and lifestyle of many participants. However, longer interactions can and should occur – at the discretion of the participant – as a means to invite people to take advantage of other services, for education (ex. safer injection or HIV/HCV prevention) and to allow for stronger relationship-building. Protecting the anonymity and confidentiality of participants is vital. The fewer rules and regulations, while still prioritizing SAP and participant safety, the more accessible the program will be. Consider the necessity and reasoning behind every requirement imposed on a participant and take nothing for granted.
Stay i n g Fo c used Syringe access programs are fundamentally about serving the needs of drug users – stay focused. When developing the basics of the program, be cautious not to lose sight of the reason the SAP exists and the people you are targeting with your program. While meeting funder and community needs is important, policies and procedures ultimately need to be about getting syringes into the hands of drug users. Consistently question if and how what is being done can better meet the drug user where she/he is at. What may make it easier for a person to use the program? If certain aspects of programming don’t seem to be working and/or participants are challenging or breaking rules, remember to ask what the program might be able to do differently or better; consider how the program could change to better meet needs and potentially avoid problems. Seek suggestions from participants about how things might be able to be done differently and take the feedback seriously. If a program always asks for suggestions, but never implements changes, participants will be less likely to offer feedback in the future.
P O LICIE S A N D PRO CEDURE S Syringe Transaction Models and Policies The syringe transaction is the primary point of contact between drug users and the program. The quality of this interaction can be critical for setting the tone of the program. When users are able to define the terms of their injection needs, it goes a long way to underline program commitment to the provision of non-judgmental, non-27-
