Attitudes of HIV healthcare Provider Attitudes Towards PWH who use Drugs and acceptance of harm reduction strategies: a cross-sectional study.

BACKGROUND

Negative attitudes toward people who use drugs (PWUD) can hinder their engagement in healthcare and contribute to poor clinical outcomes. While harm reduction-informed care may improve healthcare worker attitudes and patient experiences, limited research has examined its acceptability within HIV clinical settings.

OBJECTIVES

This study aimed to assess healthcare workers' attitudes toward PWUD and their acceptance of harm reduction principles within HIV care clinics and to examine associated sociodemographic and work-related factors.

DESIGN

Cross-sectional quantitative study.

DESIGN

In 2022, 128 healthcare workers from three HIV care clinics in Birmingham, AL and Pittsburgh, PA, completed a self-administered electronic survey via REDCap. Multivariable linear regression was used to examine associations between attitudes toward PWUD and acceptance of harm reduction practices, adjusting for relevant covariates.

METHODS

Overall, healthcare workers reported generally positive attitudes toward PWUD, though variations by location, race, and years of experience were observed. More negative attitudes toward PWUD were associated with lower harm reduction principles acceptance (b = -0.29, p = .001). Independent predictors of lower harm reduction acceptance included working in Birmingham versus Pittsburgh (b = -0.34, p = 0.001) and being identified as Black or African American versus White (b = -0.45, p = 0.001). Healthcare workers with 6-10 years and > 20 years of experience working with people with HIV reported higher harm arm reduction acceptance (b = 0.45, p = 0.003 and b = 0.62, p = 0.02, respectively), compared to those with ⩽5 years of experience.

RESULTS

These findings underscore the need for targeted interventions that improve harm reduction acceptability among HIV care workers, particularly those shaped by location, race, healthcare worker experience, and attitudes toward PWUD, to support the integration of harm reduction into HIV clinical practice.