Harm Reduction and Adaptations Among PWUD in Rural Oregon During COVID-19

Andrew Seaman, Gillian Leichtling, Erin Stack, Mary Gray, Justine Pope, Jessica E. Larsen, Judith M. Leahy, Lillian Gelberg, P. Todd Korthuis

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Coronavirus Disease 2019 (COVID-19) may influence HIV/HCV transmission risk behaviors in rural communities. We conducted semi-structured qualitative interviews with people who use drugs (PWUD) in five rural Oregon counties and asked about COVID-19 impact on substance use and harm reduction practices and their advice for improving public health responses. Participants (n = 36) reported using only methamphetamine (52.8%), only heroin (16.7%), or both (30.6%); 75% of participants reported recent injection. Three thematic categories emerged: SSP adaptations and accessibility, PWUD harm reduction practices, and policy suggestions. Participants noted the importance of SSPs to COVID-19 prevention and wellbeing, though some experienced increased barriers, leading to increased risky injection practices. Participants suggested need-based rather than one-for-one exchange, increasing syringe delivery services, encouraging secondary exchange by PWUD, and peers as trusted voices for information exchange. Rapid implementation of policy and practice changes are urgently required to improve SSP access, reinforce safer use, and prevent HIV/HCV and COVID-19 transmission.

Original languageEnglish (US)
Pages (from-to)1331-1339
Number of pages9
JournalAIDS and Behavior
Issue number5
StatePublished - May 2021


  • COVID-19
  • Harm reduction
  • Opioid use disorder
  • Rural
  • Syringe services programs

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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