The purpose of this study is to test the effectiveness of the ACCESS strategy: an organizational-level intervention that uses funding and practice facilitation to improve the organizational capacity of syringe services programs (SSPs) to implement routine, opt-out HIV and Hepatitis C (HCV) testing and linkage to care for people who inject drugs (PWID).

Inclusion Criteria:

• SSPs must:

  1. be operating in an Ending the HIV Epidemic (EHE) or Centers for Disease Control and Prevention (CDC) determined vulnerable jurisdictions;
  2. serve at least 300 unique participants per year;
  3. not currently offer opt-out HIV/HCV testing;
  4. be capable and willing to prospectively collect aggregated, site-level data on the number of participants who are: i) offered HIV/HCV screening, ii) completed these tests, and iii) linked to care, as well as provide participant demographics;
  5. have key staff that consent to participate in study surveys, qualitative interviews and practice facilitation throughout the study.

Exclusion Criteria:

• SSPs must not:

  1. currently receive or have received Frontline Communities in the United States (FOCUS) funding;
  2. have already implemented opt-out HIV/HCV testing.
  3. currently participating in SAIA-SSP-HIV (NCT06025435)