Using a Syringe Service Program-Based Community Advisory Board to Expand HIV Testing, Overdose Prevention, and PrEP...

Southern Black communities are disproportionately affected by intersecting HIV and opioid overdose epidemics. In 2022, at a local syringe service program (SSP) in Shelby County, Tennessee, only 10% of clients at two established sites identified as Black despite clear epidemiological need and prior unsuccessful efforts to increase uptake. This study developed culturally responsive strategies to increase the reach and relevance of harm reduction services within the local Black community.

We employed a community-based participatory research (CBPR) approach guided by the Consolidated Framework for Implementation Research (CFIR). A community-academic partnership convened a 12-member Community Advisory Board (CAB) with lived and professional experience in HIV, substance use, and overdose prevention. Over one year, the CAB met quarterly, supplemented by workgroups and focus groups, to identify barriers to service uptake and to co-develop a multi-component intervention plan.

The CAB produced actionable strategies organized across four CFIR domains: (1) "Lunch-and-Learns" to bridge racial discordance and support professional development (Inner Setting/staff); (2) diversification of client incentives and a "Health & Wellness" resource guide to increase service relevance (Recipient/community setting); (3) launch of a new mobile van site in a predominantly Black neighborhood (Outer Setting/location); and (4) reconfiguration of the SSP layout and service rebranding to reduce stigma (Process/service delivery).

A systematic, community-driven, geographically diverse partnership can successfully generate actionable, culturally tailored strategies to address disparities in harm reduction. This model can be adapted by other organizations to tackle similar public health inequities.