Estimated Number of People Who Inject Drugs (PWID) in the US

"We estimated nearly 3.7 million people, or 1.5% of the US adult population, injected drugs in 2018. This estimate is more than 5 times the most recent US estimate of ∼774,000 from 2011 [25]. Much of this increase is likely attributable to increases in IDU, but it is important to consider methodological differences in the creation of this 2018 estimate vs the 2011 estimate.

Cost Benefit Analysis of Opioid Treatment, Syringe Service Programs, and Test & Treat

"Although model projections can only provide estimates of health benefits and costs, such analyses can provide intuition around critical mechanisms and assumptions to inform decision making. Our main finding is that, over 20 y, high coverage (enrollment of 50% of the eligible population) of OAT [Opioid Agonist Therapy], NSPs [Needle and Syringe Programs], and Test & Treat in combination could avert nearly 43,400 (95% CI: 23,000, 74,000) HIV infections among PWID [People Who Inject Drugs] and reduce HIV prevalence among PWID by 27% (95% CI: 12%, 45%).

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.

Syringe Service Program Use and Substance Use Treatment

"In this study, there was no indication that needle-exchange use was associated with increasing drug use. Indeed, IDUs who were former users of the exchange were more likely than never-users to report substantial reductions in drug use or stopping injection altogether. Our analysis also suggested that among heroin injectors, needle-exchange participation was wholly compatible with the goals of drug treatment.

Determining Whether a Syringe Services Program Saves Money

"Methods

"The research literature on the effectiveness of syringe services programs in controlling HIV transmission among persons who inject drugs and guidelines for syringe services program that are 'functioning very well' were used to estimate the cost-saving threshold at which a syringe services program becomes cost-saving through preventing HIV infections versus lifetime treatment of HIV.

Cost Savings From Preventing HIV Infection

"Effective treatment has increased life expectancy after HIV infection, and deaths from non-AIDS-related causes now exceed deaths from AIDS for those with HIV in the US [35]. Medical costs of treating HIV-infected individuals as they age now include costs of both HIV-related and HIV-unrelated medical care. We estimated the medical cost saved by averting one HIV infection in the United States, taking into account the costs that would have been incurred by similar at-risk individuals in the absence of HIV infection.

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