The July EHE Quarterly Stakeholder Webinar featured federal and community leaders presenting best practices to improve the scale-up and use of harm reduction models including, Syringe Service Programs (SSPs) as a prevention tool to ending the HIV epidemic.
Special guests included: Regina LaBelle, Acting Director for the Office of National Drug Control Policy (ONDCP); Dr. Redonna Chandler, Director, AIDS Research Program and HEALing Communities Study National Institutes of Health and National Institute on Drug Abuse; Dr. Hansel Tookes, Associate Professor Division of Infectious Diseases, University of Miami Miller School of Medicine; and Robin Whitehead, Lead Practitioner, Lives and Souls Missional Church, Atlanta
Here are a few highlights from the presenters:
Dr. Redonna Chandler, National Institute on Drug Abuse
- Over 30 years of research demonstrates that SSPs are safe, cost-effective, and prevent infectious disease outbreaks including HIV and Hepatitis B and C.
- An economic modeling study in six U.S. cities assessed combinations of 16 evidence-informing interventions and best practices to identify combinations of strategies with the greatest health benefit while remaining cost-effective. The cities included: Atlanta, Baltimore, LA, Miami, NYC, and Seattle. SSPs were deemed cost-effective and an important part of combination strategies for EHE. Three cities met capacity and reach.
- While there is a growing need for SSPs, there is a downward trend in availability. In 2021, there are 21 fewer SSPs available nationwide and 7 states that do not have any syringe exchange programs available including: Alabama, Delaware, Kansas, Mississippi, Nebraska, South Dakota, and Wyoming.
- Scientific evidence is important, but it is only one piece of the puzzle. Federal and state support for SSPs is just as important and local advocacy is essential. Legislation allows public health departments to operate SSPs withapproval from county board of health, fiscal courts, city councils but there's increasing burden on SSPs leading to more closures.
Dr. Hansel Tookes, University of Miami
- Implementing mobile and tele-harm reduction services through SSPs can transform the traditional health care system. It provides a comprehensive hands-on approach to reach people who inject drugs (PWID) while delivering wrap-around services that can include rapid HIV testing, Hep C treatment, medication management and deliveries, linkage to care, case management, and mental health services.
- The pandemic provided a natural opportunity to pilot tele-harm reduction services. The program served 43 Ryan White patients with physician visits, provided immediate linkage to care, and initiated antiretroviral use through the SSP either on-site or in the field via the mobile unit. The pilot program reported an 80% viral suppression success rate, including 146 HIV care visits and 600 medication drops in the field.
- Tele-harm reduction services provide an integrated, enhanced model of care improving HIV linkage to care and retention intervention among PWID.
Robin Whitehead, Lives and Souls Missional Church - The HUB
- The core of the HUB’s mission is to be “less transactional and more transitional”. Through the H3 Model, HUB serves to provide help, restore hope, and allow hearts to heal.
- Faith-based communities and community-based organizations are moving beyond traditional services to include HIV testing, COVID-19 testing, Hep C testing, and more. In addition to providing meals and clothing, the HUB has distributed thousands of condoms and clean syringes to reduce transmission of HIV and infectious diseases.
- Cross-collaboration between federal agencies, local health departments, faith, and community organizations are key to effectively reaching high-risk populations. Community services are only as strong as the relationships and a whole-of-society approach makes a huge impact.
To learn more about the impact of SSPs and harm reduction methods to end the HIV epidemic, view the recording playback and presentation slides from the EHE July Quarterly Stakeholder webinar. Additional high-level updates and efforts from federal agencies to improve SSPs are available here.