{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:31:09Z","timestamp":1789104669510,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["#R01D056883"],"award-info":[{"award-number":["#R01D056883"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["#R36DA061013"],"award-info":[{"award-number":["#R36DA061013"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:p>The recent rise in HIV incidence among people who inject drugs in the United States highlights an urgent need to improve HIV testing, treatment linkage, and pre-exposure prophylaxis access in this group. Syringe services programs (SSPs) play a critical role by offering or linking clients to these services, yet little is known about how such care is delivered. Informed by the Consolidated Framework for Implementation Research, we conducted qualitative interviews with 41 representatives from 27 SSPs across the United States to characterize the current service delivery landscape, identify barriers to care, and explore modifiable implementation determinants. Rapid qualitative analysis revealed four primary HIV service delivery models: \u201cone-stop shop\u201d offering integrated, on-site HIV testing and follow-up care provided by the SSP; \u201ctest and refer\u201d with integrated, on-site testing services followed by referrals to external partners for follow-up care; \u201cco-located services\u201d with SSPs relying on external partner organizations to provide HIV testing (and additional services) on-site; and \u201chand-off\u201d involving referrals to off-site, external partners for HIV testing and follow-up care. SSPs faced varied implementation challenges, including staffing, funding, and space constraints; competing priorities; availability and accessibility of local partnerships; as well as SSP culture, which values participant autonomy (recipient-centeredness). These contextual factors influenced the feasibility and acceptability of HIV services and why SSPs adopted a particular service delivery model. To strengthen HIV prevention and care in SSPs, tailored implementation strategies are needed that account for programs\u2019 unique constraints and capacities.<\/jats:p>","DOI":"10.1177\/10872914251376934","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T15:15:42Z","timestamp":1757603742000},"page":"441-449","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["HIV Services Implementation Within US Syringe Services Programs: A Qualitative Exploration"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7884-6901","authenticated-orcid":false,"given":"Alexis M.","family":"Roth","sequence":"first","affiliation":[{"name":"Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2010-8008","authenticated-orcid":false,"given":"Elana","family":"Forman","sequence":"additional","affiliation":[{"name":"Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher F.","family":"Akiba","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Eger","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, San Diego, La Jolla, California, USA."},{"name":"School of Social Work, San Diego State University, San Diego, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Laurano","sequence":"additional","affiliation":[{"name":"Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby L.","family":"Huffaker","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila V.","family":"Patel","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Smith","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barrot H.","family":"Lambdin","sequence":"additional","affiliation":[{"name":"RTI International, Research Triangle Park, Durham, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-1919","authenticated-orcid":false,"given":"Angela R.","family":"Bazzi","sequence":"additional","affiliation":[{"name":"Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, California, USA."},{"name":"School of Public Health, Boston University, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002769"},{"key":"e_1_3_5_3_2","unstructured":"U.S. Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States 2018\u20132022. 2024."},{"key":"e_1_3_5_4_2","first-page":"1","volume-title":"Health, Rights and Drugs\u2014Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs","author":"Joint United Nations Programme on HIV\/AIDS","year":"2019","unstructured":"Joint United Nations Programme on HIV\/AIDS. Health, Rights and Drugs\u2014Harm Reduction, Decriminalization and Zero Discrimination for People Who Use Drugs. UNAIDS: Geneva, Switzerland; 2019:1\u201368."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.05.044"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.5281\/zenodo.14018958"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/10550887.2020.1771235"},{"key":"e_1_3_5_8_2","unstructured":"U.S. Centers for Disease Control and Prevention [CDC]. HIV Surveillance Special Report: HIV Infection Risk Prevention and Testing Behaviors Among Persons Who Inject Drugs National HIV Behavioral Surveillance 20 U.S. Cities 2022. 2024. Available from: https:\/\/stacks.cdc.gov\/view\/cdc\/150464"},{"key":"e_1_3_5_9_2","volume-title":"Guidance on Testing and Counselling for HIV in Settings Attended by People Who Inject Drugs: Improving Access to Treatment, Care and Prevention","author":"U.S. Department of Health and Human Services (HHS)","year":"2009","unstructured":"U.S. Department of Health and Human Services (HHS). Guidance on Testing and Counselling for HIV in Settings Attended by People Who Inject Drugs: Improving Access to Treatment, Care and Prevention. WHO; 2009."},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001792"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2024.100757"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmqr.2024.100421"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0"},{"key":"e_1_3_5_14_2","unstructured":"CFIR Research Team \u2013 Center for Clinical Management Research. The Consolidated Framework for Implementation Research \u2013 Technical Assistance for Users of the CFIR framework. CFIR Guide. 2022. Available from: https:\/\/cfirguide.org\/ [Last accessed: August18 2025]."},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_3_5_16_2","unstructured":"North American Syringe Exchange Network (NASEN). The NASEN Directory. 2025. Available from: https:\/\/nasen.org\/"},{"key":"e_1_3_5_17_2","unstructured":"U.S. Centers for Disease Control and Prevention [CDC]. HIV Surveillance Report 2018 (updated 2020). 2020."},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.5771\/9780759123212"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-018-02387-3"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-019-0853-y"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s43477-023-00086-3"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109323"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-02886-2"},{"key":"e_1_3_5_24_2","unstructured":"Substance Abuse and Mental Health Services Administration. Harm Reduction Framework: Center for Substance Abuse Prevention Substance Abuse and Mental Health Services Administration; 2023."},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-071723-112620"},{"issue":"1","key":"e_1_3_5_26_2","first-page":"513","article-title":"Study protocol for an efficacy trial of the \u201cPrEP for Health\u201d intervention to increase HIV PrEP use among people who inject drugs","volume":"23","author":"Bazzi AR","year":"2023","unstructured":"Bazzi AR, , Bordeu M, , Baumgartner K, et al. Study protocol for an efficacy trial of the \u201cPrEP for Health\u201d intervention to increase HIV PrEP use among people who inject drugs. BMC Public Health. 2023-03-17, 2023; 23(1):513.","journal-title":"BMC Public Health. 2023-03-17"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-022-00595-8"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-023-07074-w"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-024-00447-9"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102875"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-025-04833-5"}],"container-title":["AIDS Patient Care and STDs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10872914251376934","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251376934","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10872914251376934","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T14:22:59Z","timestamp":1787149379000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10872914251376934"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,11]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11,1]]}},"alternative-id":["10.1177\/10872914251376934"],"URL":"https:\/\/doi.org\/10.1177\/10872914251376934","relation":{},"ISSN":["1087-2914","1557-7449"],"issn-type":[{"value":"1087-2914","type":"print"},{"value":"1557-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,11]]}}}