Closure of Syringe Service Programs Increases Risk of Rebound HIV Outbreaks

"This analysis presents the first study, to our knowledge, to quantitively examine the impact of SSP closure on HIV incidence using a modeling approach. In a rural American setting that had previously experienced an HIV outbreak among PWID, our modeling results suggest that closing an existing SSP would likely lead to a rebound HIV outbreak, with a 1.6-fold increase in incident infections among PWID in 5 years relative to SSP sustainment. The potential impact of SSP closure was found to be substantially greater for other settings with lower baseline HIV prevalence (in which a larger share of the population is susceptible to HIV infection). Although delaying SSP closure with another renewal was found to reduce the size of the rebound, sustaining SSP operation and associated health services will be imperative to maintain long-term epidemic control."