{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:00:52Z","timestamp":1787605252240,"version":"build-2736575974"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,9,19]],"date-time":"2021-09-19T00:00:00Z","timestamp":1632009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate whether Kentucky counties that established a new syringe services program realized a significant decline in the incidence rate of a set of infectious disease diagnoses commonly transmitted via injection drug use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Longitudinal count models of within\u2010county rates of newly diagnosed infections among populations at risk were estimated using Medicaid claims\/encounters data. Generalized estimating equation models were used to report incident rate ratios of 6 diagnoses: (1) HIV; (2) hepatitis C; (3) hepatitis B; (4) osteomyelitis; (5) endocarditis; and (6) skin\/soft tissue infection. To investigate whether a delay in effect was present, separate models were fit to estimate the effects of establishing a syringe services program: at its opening date, and again at 1, 3, and 6 months postopening date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Taken together, the aggregated within\u2010county incidence rate of these 6 diagnoses was significantly lower following the implementation of a syringe services program (<jats:italic>P<\/jats:italic> &lt; .05). Our models estimated that counties which opted to open a syringe services program realized an approximate month\u2010over\u2010month decline in new diagnoses of 0.5% among the population at risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results lend further support to previous conclusions made in the public health literature regarding the efficacy of syringe services programs. Specifically, declines in incidence rates were observable beginning at 1 month post syringe services program opening. These results are particularly notable due to the typical setting in which these syringe services programs operated\u2014rural communities of fewer than 40,000 residents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12623","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T05:59:13Z","timestamp":1632117553000},"page":"620-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Syringe services programs in the Bluegrass: Evidence of population health benefits using Kentucky Medicaid data"],"prefix":"10.1111","volume":"38","author":[{"given":"Cameron","family":"Bushling","sequence":"first","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services, Office of Health Data and Analytics Division of Analytics  Frankfort Kentucky USA"},{"name":"University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1971-8306","authenticated-orcid":false,"given":"Matthew T.","family":"Walton","sequence":"additional","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services, Office of Health Data and Analytics Division of Analytics  Frankfort Kentucky USA"},{"name":"University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8480-6228","authenticated-orcid":false,"given":"Kailyn L.","family":"Conner","sequence":"additional","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services, Office of Health Data and Analytics Division of Analytics  Frankfort Kentucky USA"},{"name":"University of Kentucky  Lexington Kentucky USA"},{"name":"Kentucky Cabinet for Health and Family Services Department for Medicaid Services  Frankfort Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilbert","family":"Liu","sequence":"additional","affiliation":[{"name":"Partners for Kids Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ardis","family":"Hoven","sequence":"additional","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services Department for Public Health  Frankfort Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessin","family":"Joseph","sequence":"additional","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services Department for Medicaid Services  Frankfort Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Taylor","sequence":"additional","affiliation":[{"name":"Kentucky Cabinet for Health and Family Services, Office of Health Data and Analytics Division of Analytics  Frankfort Kentucky USA"},{"name":"University of Kentucky  Lexington Kentucky USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,19]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Institute on Drug Abuse.https:\/\/www.drugabuse.gov\/drug\u2010topics\/opioids\/opioid\u2010overdose\u2010crisis. 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