Supporting Harm Reduction Programs

Project NEXUS

Background

Project Needle Exchange Utilization Survey (NEXUS), also known as the Injection Drug Use Surveillance Project (IDU-SP) is a multisite, cross-sectional surveillance survey of people who use drugs (PWUD) implemented in syringe services programs (SSPs) in the United States. This project is modeled on CDC’s National HIV Behavioral Surveillance (NHBS) system and is intended to fill current public health data gaps.

 

This project is part of a collaboration with the Centers for Disease Control and Prevention (CDC) and the University of Washington (UW) to establish a national program for measuring services provided by SSPs and their impact on their participants.

 

Goals and Objectives

The goal of Project NEXUS is to conduct ongoing surveillance in collaboration with SSPs among people who inject with drugs (PWID) and their drug using peers by documenting:

  • HIV and HCV infection prevalence
  • Other drug-use related health outcomes
  • Risk behaviors
  • Injection risk networks
  • Receipt of prevention services
  • Barriers to prevention and care.

The quantitative survey collects information on drug use related adverse health outcomes, risk behaviors, injection risk networks, receipt of prevention services, and barriers to prevention and care. HIV and HCV testing enables the project to estimate prevalence and store leftover blood specimen for future testing. Data from this project will be used to inform planning and evaluation of prevention programs that aim to reduce injection-related adverse health outcomes. Lessons learned from this project will inform efforts to establish an ongoing surveillance of injection drug use and associated risks at the national and local levels.

 

Project NEXUS Sites

Project NEXUS is being conducted in two rounds of data collection at ten total SSPs. SSPs were selected based on various characteristics such as region, size, urbanicity, and syringe distribution model. NEXUS Round 1 was conducted in 2021-2022 and partnered with SSPs in six places: Sacramento, CA, Ellensburg, WA, Missoula, MT, Madison, WI, New Haven, CT, and Wilmington, NC. NEXUS Round 2 is being conducted in 2023 and is partnering with SSPs in four places: New Orleans, LA, Anderson, IN, Newark, NJ, and Philadelphia, PA.

A map of the United States showing Project NEXUS sites. Project NEXUS Round 1 states are in green with red location markers at each city: Ellensburg, Washington; Sacramento, California; Missoula, Montana; Madison, Wisconsin; New Haven, Connecticut; Wilmington, North Carolina. Project NEXUS Round 2 states are in purple with red location markers at each city: New Orleans, Louisiana; Anderson, Indiana; Philadelphia, Pennsylvania; Newark, New Jersey.

Manuscripts and Presentations

 

2022 National Harm Reduction Conference

Initial findings were presented at the 2022 National Harm Reduction Conference in San Juan, Puerto Rico put on by the National Harm Reduction Coalition.

Key Findings:

  • Over 1500 people who use drugs were recruited from six geographically diverse sites between 2021-2022
  • Disproportionately affected racial/ethnic groups were well represented in the sample
  • Majority of participants reported both injection and non-injection drug use within the past 6 months
  • Methamphetamine use was higher in western sites (WA, CA, MT)
  • Opioid overdose was more common than stimulant overdose
  • Most people surveyed had acquired naloxone in the past 6 months but there is still an unmet need

Additional reports, presentations, and papers will be posted here once available.