Perspectives of healthcare workers about the delivery and evaluation of harm reduction services for people living with HIV who use substances

Abstract

Background: Harm reduction (HR) programs and services have strong empirical support in reducing the negative outcomes associated with substance use and are becoming increasingly recognized across the continuum of healthcare services. Aims: To explore frontline healthcare workers (HWs) experiences and perspectives on the benefits and challenges of providing HR programming and care to HIV-positive clients. Methods: A 20 question survey, inclusive of open-ended questions and quantitative rating scales, was completed by HWs at two HIV/AIDS dedicated facilities in Canada implementing HR services. Findings: A total of 64 HWs participated in the survey, with an average of 6.2 years (range: 0.5–18) of experience in HR programs. HWs identified healthcare system engagement and building positive client relationships as key outcomes for evaluation of HR programs. Personal and inter-team related dynamics were highlighted as challenges experienced when utilizing HR in the provision of care. The absence of clear procedures and policies were identified by HWs as barriers to effective implementation of HR programming. Conclusions: The results of this study can be utilized to inform, establish, and guide HR programs, services, and policy development to ensure the delivery of quality care.

Keywords

• harm reduction
• hiv
• aids
• healthcare providers
• survey