Abstract
The Landscape of HIV Services Delivery in U.S. Syringe Services Programs: A Qualitative Exploration of Current Models and Opportunities
Drug and alcohol dependence, v 267(16), 112150
01 Feb 2025
Abstract
Aim: To explore how diverse syringe services programs (SSPs) deliver HIV services across the U.S., where a resurgence in transmission has disproportionately affected people who use drugs (PWUD).
Methods: From May–November 2023, we recruited a purposive sample of SSPs offering HIV testing to PWUD. Qualitative interviews and thematic analysis explored current models of delivering HIV services, including HIV testing and prevention and treatment referrals.
Results: Twenty-three SSPs across the U.S. (Northeast: n=6; South: n=7; Midwest: n=4; West: n=6) were interviewed. Seventeen (74%) were nonprofit organizations; six (26%) were operated by health departments. Nine (39%) provided onsite confirmatory HIV testing via blood draw. We identified four overarching HIV services delivery models: (1) “Test and Refer,” in which SSP staff provide HIV testing and make subsequent referrals to external HIV prevention and treatment services; (2) “Co-Located Services,” in which external organizations sharing space with SSPs provide HIV testing and subsequent referrals; (3) “One-Stop-Shop,” in which SSP staff provide HIV testing and directly navigate participants to HIV prevention or treatment services provided within SSPs; and (4) “Handoff,” in which SSP staff provide participants with information about and referrals to local HIV testing and other services offered externally. Which HIV services delivery models were implemented was influenced by multilevel factors, including resource constraints (e.g., funding, staffing, space); perceived “fit” of HIV services within organizations’ missions; participants’ immediate needs (e.g., accessing syringes or buprenorphine); and external contexts in which other public health concerns were prioritized (e.g., local Hepatitis C or overdose epidemics).
Conclusions: SSPs are critical access points for HIV services for PWUD, especially vulnerable individuals injecting opioids. Yet, there is significant variation in delivery models implementation. Efforts to attend to multilevel implementation considerations and in turn optimize HIV services delivered through SSPs could help address HIV resurgence among PWUD.
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Details
- Title
- The Landscape of HIV Services Delivery in U.S. Syringe Services Programs: A Qualitative Exploration of Current Models and Opportunities
- Creators
- Elana Forman - Dornsife School of Public Health, Drexel UniversityAlexis M. Roth - Drexel UniversityShelby L. Huffaker - University of California, San DiegoRose Laurano - Drexel UniversityWilliam H. Eger - University of California, San DiegoChristopher F. Akiba - RTI InternationalSheila V. Patel - RTI InternationalJessica Smith - RTI InternationalBarrot H. Lambdin - RTI InternationalAngela R. Bazzi - University of California, San Diego
- Publication Details
- Drug and alcohol dependence, v 267(16), 112150
- Conference
- 2024 Annual Meeting of the College on Problems of Drug Dependence (Montreal, Canada, 15 Jun 2024–19 Jun 2024)
- Publisher
- Elsevier
- Number of pages
- 1
- Grant note
- Financial Support: This work was supported by the National Institute on Drug Abuse (NIDA; grants R01DA056883 and T32DA023356).
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Community Health and Prevention
- Web of Science ID
- WOS:001433491100020
- Other Identifier
- 991022027537804721
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychiatry
- Substance Abuse