Factors associated with willingness to use a public health vending machine in a tribal community in the southern plains.

Abstract

Few Tribal Nations in the United States (US) have implemented public health vending machines (PHVMs) to meet the infectious disease and overdose prevention needs of people who use drugs (PWUD). Better understanding willingness to use PHVMs on American Indian reservations may inform PHVM implementation. This study used cross-sectional data from a sample of PWUD (N = 209) recruited on a rural sector of an American Indian reservation in the Southern Plains of the US to explore factors associated with hypothetical willingness to use a PHVM. Most of our sample were men (57.4%), identified as heterosexual (90.4%), and self-identified as American Indian (53.6%). Over half (60.8%) reported recent methamphetamine use and a third (33.0%) reported recent opioid use. Two-thirds (64.6%) reported being willing to use a PHVM to obtain free sterile injection equipment and naloxone if it were available. Being employed and having recently witnessed an overdose were independently associated with willingness to use a PHVM [adjusted odds ratio (aOR) = 2.94, 95%CI = 1.402-6.166 and aOR = 3.068, 95%CI = 1.458-6.455, respectively]. Drug use stigma was associated with willingness to use a PHVM (aOR = 1.056, 95%CI = 1.008-1.108). Identifying as American Indian was associated with lower odds of willingness to use a PHVM (aOR = 0.519, 95%CI = 0.271-0.995). The proportion of reported family members who used drugs was inversely associated with willingness to use a PHVM (aOR = 0.764, 95%CI = 0.589-0.989). Future work should explore PHVM implementation across diverse American Indian cultures.