Abstract
With the convergence of the opioid and stimulant crises in the United States, there has been a significant increase in the prevalence of people who inject drugs (PWID), as well as incidence of preventable overdose death. PWID are at an amplified vulnerability for experiencing a multitude of harms related to their substance use, including viral (e.g. HIV, Hepatitis C) and bacterial infections (e.g. skin and soft tissue, endocarditis) and fatal overdose due to lack of access to sterile injection equipment and naloxone. The fundamental public health intervention to prevent HIV and HCV infection among PWID are syringe services programs (SSPs), an evidence-based harm reduction strategy that offers access to free, sterile injection equipment. SSPs have been researched for over 40 years, providing extensive evidence supporting SSPs’ effectiveness at reducing HIV infection among this target population, and have been highlighted in the Ending the HIV Epidemic: Plan for America. In 2016, the state of Florida passed the Infectious Disease Elimination Act (IDEA) that authorized the first legal SSP at the University of Miami. Most recently, new legislation has authorized Florida counties to implement SSPs. Using pilot data from the Miami-Dade SSP and state-level surveillance data, guided by the Getting to Outcomes implementation model, this dissertation aims to provide information on 1) resource allocation, 2) syringe distribution policies, and 3) targeted areas in Florida where rapid SSP policy implementation is needed. Findings from this dissertation highlight that SSPs are low-cost, evidence-based programs that engage differing populations of PWID across the state of Florida. In addition, the findings from the predictive modeling can be utilized by health departments and local advocates to inform state and local policy makers and health officials regarding implementation of SSP policy.