Year of Publication



Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Dr. April Young

Committee Member

Dr. Laura Fanucchi

Committee Member

Dr. Rachel Vickers-Smith

Committee Member

Dr. Amanda Fallin-Bennett


Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who injected with a needle that had been used by someone else [aOR=1.758; 95% CI: 1.301-2.376], and those who injected more frequently [aOR=1.864; 95% CI: 1.233-2.818]. Furthermore, living further from an SSP [aOR=2.353; 95% CI: 1.429-3.874] was associated with increased syringe reuse.

Conclusion: Syringe reuse among PWID in rural Kentucky is prevalent. This practice has the potential for transmission of infectious diseases. Furthermore, syringe reuse was higher among those sharing syringes and those injecting methamphetamine. Proximity to SSPs was protective. Increasing access to SSPs may mitigate risks associated with syringe reuse and support the health of PWID in rural Appalachia Kentucky.

Available for download on Sunday, April 21, 2024