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

Area of Science:

• Public Health
• Health Equity
• Community-Based Research

Background:

• Southern Black communities disproportionately experience HIV and opioid overdose epidemics.
• Syringe Service Programs (SSPs) in Shelby County, Tennessee, had low Black client uptake (10%) despite identified need.
• Previous efforts to increase service reach within the Black community were unsuccessful.

Purpose of the Study:

• To develop culturally responsive strategies to enhance the reach and relevance of harm reduction services.
• To address disparities in HIV and opioid overdose prevention services among the Black community.

Main Methods:

• A community-based participatory research (CBPR) approach was used, guided by the Consolidated Framework for Implementation Research (CFIR).
• A Community Advisory Board (CAB) comprising individuals with lived and professional experience was convened.
• The CAB identified barriers and co-developed a multi-component intervention plan over one year through meetings and focus groups.

Main Results:

• Strategies were developed across four CFIR domains: staff training, enhanced client incentives and resources, a mobile van site in a Black neighborhood, and stigma-reduction measures for service delivery.
• "Lunch-and-Learns" addressed racial discordance and professional development.
• A "Health & Wellness" resource guide and diversified incentives increased service relevance, while a mobile van and service rebranding improved access and reduced stigma.

Conclusions:

• A systematic, community-driven partnership successfully generated actionable, culturally tailored strategies to address harm reduction disparities.
• This CBPR model can be adapted by other organizations to tackle similar public health inequities.
• Culturally specific interventions are crucial for equitable public health service delivery.