A Step Forward for HIV Prevention

DHHS issues guidance on use of federal funds for syringe services programs

The U.S. Department of Health and Human Services has issued guidelines on the use of federal funds to implement or expand syringe services programs (SSPs), which have been shown to reduce the transmission of HIV and viral hepatitis among people who inject drugs (PWID). The guidance follows Congress’s decision in December to lift the longstanding ban on federal funding for SSPs.

That measure, which was included in an omnibus spending bill and had bipartisan support, allowed states and communities to use federal funds to pay for all operational costs of SSPs so long as they demonstrated a need. It did not permit the funds be used to pay for syringes themselves.

“This is a major milestone,” said Greg Millett, amfAR vice president and director of public policy. “We commend HHS for moving expeditiously to issue these guidelines and look forward to working with other advocacy groups to make sure these guidelines are implemented in those regions of the country where elevated hepatitis C rates, HIV rates, and injection drug use converge.”  

Injection drug use, particularly of heroin and opioids, is on the rise, with the Centers for Disease Control and Prevention reporting a 150 percent increase in acute cases of Hepatitis C in recent years because of risky injection drug use. Last summer, Scott County in Indiana saw an outbreak of HIV and Hepatitis C tied to injection drug use. Republican congressional leaders in Kentucky, which has the nation’s highest rates of hepatitis C cases, pushed for the partial repeal of the ban on federal funding for SSPs.

Scientific evidence demonstrates that SSPs reduce the transmission of HIV and other blood-borne diseases without increasing drug use. Such programs also encourage PWID to seek substance abuse treatment and are cost effective, saving millions of dollars in HIV and hepatitis C treatment costs.

The HHS guidance requires that state, local, tribal, and territorial health departments consult with the CDC and provide evidence that their jurisdiction is (1) experiencing, or (2) at risk for significant increases in viral hepatitis infections or an HIV outbreak due to injection drug use. If the CDC determines there is sufficient evidence, the departments can apply to their respective federal agencies to direct funds to support approved SSP activities.