Project Access – Drug Users’ Barriers to Counseling and Testing

Structural Barriers:

Restricted hours for C&T

  • Schedules of C&T hours vary and can be unpredictable
  • Lab hours can prevent late night and weekend testing

Lack of Transportation

  • No convenient testing available in some communities of high risk clients

Blood draw Logistics

  • Phlebotomists lack experience drawing blood from injection drug using clients
  • Fear of needles among non-IDU participants

Insensitive providers

  • Testing staff insensitive toward participants due to their drug use
  • Reports of outreach workers escorting participants and advocating for participants at HIV C&T and other service settings

Personal Barriers:

HIV Stigma

HIV stigma varied greatly between individuals and communities, influencing how participants felt about the following:

  • receiving their HIV test results in a public space (mobile van)
  • outreach staff knowing their HIV status
  • disclosing their HIV status to friends and family

Fear of Positive Results

  • Waiting period anxiety
  • Lack of definite plan if positive

Little Perceived Risk

  • Risk for contracting HIV perceived as minimal.
  • Perceived risks often associated with past behaviors not with current ongoing behavior
  • Participants generally apt to assess their drug-related risks more clearly than their sexual risk

Competing Concerns

  • Need for immediate housing and social services
  • Inadequate availability of drug treatment (esp. methadone maintenance)
  • Needs of drug habit: hustling and procuring drugs

Last modified: February 24, 2011