Syringe Exchange Staff Want to Offer Reproductive Health Care but Face Barriers

A qualitative study published in Harm Reduction Journal on 9 October 2026 reports that staff at New York State syringe service programs want to integrate sexual and reproductive health care into their services but are constrained by limited facilities, supplies, funding and training. The study, led by Polly Faust with colleagues including Sharon Stancliff, interviewed managers, clinicians and frontline staff from 14 programs to assess their capability to meet the reproductive health needs of people who use drugs.

The research addressed a gap shaped by stigma on two fronts. People who use drugs are a marginalized population that faces barriers seeking reproductive health care in a culture that stigmatizes both drug use and reproductive health care itself. Syringe service programs were originally created to slow the spread of HIV among people who use drugs and have since expanded, under a harm reduction framework, to support other fundamental necessities.

Methodologically, the study relied on semi-structured, open-ended interviews with program leadership and staff. The researchers applied thematic analysis to interview notes covering the programs’ reproductive health education, counseling, supplies, onsite care, and referrals for contraception, prenatal care, abortion and sexually transmitted infections, as well as the staff’s goals for future development in this area. Because the design was qualitative and drew on staff perspectives, the findings describe program capacity and staff perceptions rather than measuring health outcomes among participants.

The interviews showed that programs already provide some onsite sexual health services, particularly around HIV prevention, which reflects their historical mission. Respondents emphasized that rapport-building and trust between staff and the people who use their services was essential to participants’ acceptance of those services. This relational foundation, staff said, is what makes harm reduction settings a potentially powerful point of contact for broader health needs.

Reproductive health care, however, was not systematically embedded in routine programming. Staff described reproductive health services as responses to individual participants’ crises rather than services built into regular program operations. Their ability to provide this care was limited by facilities, supplies, funding and training, and staff expressed a wish to provide a broader range of care onsite, describing an aspiration captured in the study’s title framing of wanting to offer everything.

Pregnancy-related services emerged as a particular weak point. The programs had few pregnant participants, and respondents noted that women and pregnant people who use drugs might avoid the programs altogether due to fears of stigma and of child protective service interventions. This avoidance means that a population facing extreme hardships when reproductive health needs arise may also be the least likely to enter the settings best positioned to help them.

The authors conclude that harm reduction settings have unique opportunities to reach women, pregnant and parenting people who use drugs, yet face several barriers to providing reproductive health care. They argue that greater training in reproductive health and additional funding could help these programs meet their stated desire to serve the intersecting needs of this population through a one-stop-shop approach, consolidating services that participants currently must seek elsewhere.

As an interview-based study of staff at 14 programs in a single state, the research characterizes provider capability and perceived barriers rather than documenting service uptake or health effects. Even so, it identifies concrete, staff-identified levers, training and funding, through which syringe service programs might extend from HIV prevention toward the wider reproductive health care their participants need.

Subject of Research: A qualitative study of New York State syringe service program staff on integrating sexual and reproductive health care

Article Title: “We would love to offer everything:” findings from a qualitative study of syringe exchange program staff on integrating sexual and reproductive health care into New York State syringe exchange programs

Article References: Faust, P., Zurashvili, T., Colón, K., Logan, M. M., & Stancliff, S. (2026). “We would love to offer everything:” findings from a qualitative study of syringe exchange program staff on integrating sexual and reproductive health care into New York State syringe exchange programs. Harm Reduction Journal. https://doi.org/10.1186/s12954-026-01527-6

Image Credits: AI Generated

DOI: 10.1186/s12954-026-01527-6

Keywords: syringe service programs, harm reduction, reproductive health, people who use drugs, qualitative research, New York State, HIV prevention, stigma, pregnancy, contraception, love, offer