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Syringe services programs (SSPs) offer vital HIV testing and care for people who inject drugs. Understanding their diverse service models and implementation challenges is key to improving HIV prevention and treatment access.

Keywords:
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Area of Science:

  • Public Health
  • Implementation Science
  • Infectious Disease Epidemiology

Background:

  • Rising HIV incidence among people who inject drugs (PWID) in the US necessitates improved HIV testing, linkage to care, and pre-exposure prophylaxis (PrEP).
  • Syringe services programs (SSPs) are crucial for delivering these HIV prevention and care services to PWID, but their service delivery models are not well understood.

Purpose of the Study:

  • To characterize HIV service delivery models within US-based SSPs.
  • To identify barriers and modifiable determinants influencing the implementation of HIV services in SSPs.
  • To inform the development of tailored implementation strategies for enhancing HIV prevention and care within SSPs.

Main Methods:

  • Qualitative interviews were conducted with 41 representatives from 27 SSPs across the United States.
  • The Consolidated Framework for Implementation Research guided the study's approach.
  • Rapid qualitative analysis was used to analyze interview data.

Main Results:

  • Four distinct HIV service delivery models were identified: "one-stop shop," "test and refer," "co-located services," and "hand-off."
  • Common implementation challenges included staffing, funding, space limitations, competing priorities, partnership accessibility, and organizational culture.
  • Contextual factors significantly influenced the adoption and feasibility of different HIV service delivery models.

Conclusions:

  • SSPs utilize diverse models to deliver HIV services, each with unique implementation challenges.
  • Tailored implementation strategies are essential to address program-specific constraints and capacities for strengthening HIV prevention and care.
  • Addressing barriers related to resources, partnerships, and organizational culture can optimize HIV service delivery in SSPs.