OBJECTIVES: People who inject drugs (PWID) underutilize primary and preventive health services. To inform strategies for improving PWID healthcare engagement, we elicited PWID preferences for receiving wound care, HIV and hepatitis C virus (HCV) screening, and buprenorphine treatment for opioid use disorder using discrete choice experiments (DCEs).
METHODS: We conducted DCEs with PWID at 14 syringe services programs (SSPs) in the United States. The DCEs presented 10 service-specific pairs of random combinations of care delivery attributes (eg, location), with various levels (eg, SSP, urgent care), with an opt-out alternative. Participants completed the HIV/HCV screening DCE if not seropositive, and the buprenorphine DCE if they self-reported buprenorphine treatment history or interest; all completed the wound care DCE. We identified latent classes and estimated measures of preference using multinomial logit.
RESULTS: We selected 3-group latent class solutions for each DCE. Across all services, participants valued shorter travel times, wait times, and waitlists; >/=1 group per DCE strongly preferred receiving services at SSPs. Wound care (n = 546) groups differed by their strength of preferences for service location and care comprehensiveness. All HIV/HCV screening (n = 403) groups preferred walk-in appointments and on-site fingerstick screening; groups differed by strength of preferences for locations and travel times. All buprenorphine (n = 261) groups preferred less punitive consequences for positive urine toxicology results and differed by their preferences for locations.
CONCLUSIONS: Most participants strongly preferred shorter travel times and wait times; for all services, >/=1 group preferred SSP settings. By addressing PWID preferences, these findings can help improve healthcare engagement.
Syringe services participants’ preferences for wound care, HIV/Hepatitis C virus screening, and opioid use disorder treatment: A discrete choice experiment
Value in Health [Epub 2025 Nov 19]. doi: 10.1016/j.jval.2025.11.001.