Theme: Epidemiology & Public Health Research Year: 2022
People who inject drugs (PWID) are at an amplified vulnerability for experiencing a multitude of
harms related to their substance use, including viral (e.g. HIV, HCV) and bacterial infections (e.g.
endocarditis). Implementation of evidence-based interventions, such as syringe services programs
(SSP), remains imperative, particularly in locations at an increased risk of HIV outbreaks. This study
aims to identify communities in Florida that are high-priority locations for SSP implementation by
examining state-level data related to the substance use and overdose crises.
State-level surveillance data were aggregated at the ZIP Code Tabulation Area (ZCTA) for 2017. We
used confirmed cases of acute HCV infection as a proxy of injection drug use. Least Absolute
Selection and Shrinkage Operator (LASSO) regression was used to develop a machine learning
model to identify significant indicators of acute HCV infection and high-priority areas for SSP
implementation due to their increased vulnerability to an HIV outbreak.
The final model retained three variables of importance: 1) the number of drug-associated skin and
soft tissue infection hospitalizations, 2) the number of chronic HCV infections in people aged 18-39,
and 3) the number of drug-associated endocarditis hospitalizations. High-priority SSP
implementation locations were identified in both urban and rural communities outside of current
Ending the HIV Epidemic counties.
SSPs are long researched, safe, and effective evidence-based programs that offer a variety of
services that reduce disease transmission and assist with combating the overdose crisis.
Opportunities to increase services in much needed regions across the state now exist in Florida as
supported by the expansion of the Infectious Disease Elimination Act of 2019. This study provides
details where potential areas of concern may be and highlights regions where future evidence-based
harm reduction programs, such as SSPs, would be useful to reduce opioid overdoses and disease
transmission among PWID.
Disclosure of Interest Statement: