Rapid Identification of HIV Among People Who Inject Drugs: Tampa, FL, 2024.

Syringe Service Programs (SSPs) have proven effective in reducing HIV transmission among people who inject drugs (PWID). However, early HIV detection remains an underutilized opportunity for preventing transmission and curbing outbreaks. This paper emphasizes the impact of implementing routine, opt-out HIV screening within SSPs as a strategy to enhance early detection and prevention efforts. In 2022, the IDEA Exchange Tampa, Florida's second legally sanctioned SSP, transitioned from an opt-in to a routine opt-out screening model. This shift identified six anonymous participants with acute and untreated HIV, including three confirmed seroconversions (within 59 days of a prior negative test), two individuals diagnosed during their first HIV screening at the SSP with 'unknown infection duration', and one previously diagnosed individual who had been out of care. Through a robust linkage-to-care framework, all six participants were linked to care within an average of 7.5 days (100% linkage rate). Clinical counseling sessions revealed that these individuals were part of an interconnected 26-person risk network involving needle-sharing and sex exchange behaviors. These findings underscore the critical role of systematic opt-out screening in SSPs for accelerating case detection and facilitating rapid linkage-to-care. Expanding routine, opt-out HIV screening at SSPs is essential to improving detection, curbing outbreaks, and advancing the goals of the Ending the HIV Epidemic (EHE) initiative.