Rural Oregon HIV Services Access Program for People Who Inject Drugs - Rural Oregon HIV Services Access Program for People Who Inject Drugs (HSAPP) will target primarily Black, Indigenous, and People of Color (BIPOC) people who inject drugs (PWID) across HIV Alliance’s current syringe services program (SSP) service area. The service area includes six Oregon counties: Lane, Marion, Douglas, Josephine, Curry, and Coos. This targeted program will be comprehensive, client centered, trauma informed, and culturally competent and utilize evidence-based strategies to deliver HIV prevention and care as well as essential support services to BIPOC PIWD/PWID in rural Oregon. The program will build on existing services offered by HIV Alliance—our SSP in particular—and our strong rapport and trusting relationships with the target population as well as longstanding partnerships with other community organizations, health departments, government agencies, and clinical service providers in our service region. To achieve our goals, Rural Oregon HSAPP will provide BIOOC PWID/PWID in the service area with (1) syringe services and overdose prevention training and supplies in partnership with organizations serving BIPOC; (2) testing for HIV, HCV, Gonorrhea, Chlamydia, and Syphilis at HIV Alliance SSPs, at testing events, in the community, and at locations frequented by PWID and BIPOC; (3) linkage to HIV, for both newly diagnosed people living with HIV and previously diagnosed people living with HIV who are out of care, within 30 days; (4) referral to Partner Services in collaboration with local public health departments; (5) medical adherence services through HIV Alliance’s Care Coordination program; (6) referrals to PrEP/nPEP via HIV Alliance’s PrEP/nPEP Navigation program; (7) safer sex supplies and education; (8) street (community-based) outreach; and (9) information and referral to other services at HIV Alliance (e.g., health insurance enrollment assistance, behavioral health/peer support services) and in the local community (e.g., treatment for substance/opioid use disorders, social services, housing assistance). In addition, HIV Alliance will utilize existing formal agreements and establish new agreements with local public health departments to share data and support cluster response activities, and state and local health departments will be supported with Data-to-Care efforts. The purpose of the program is to mitigate access barriers, decrease health disparities, and ultimately contribute to reducing high rates of HIV transmission among BIPOC PWID/PWID in Oregon. Expected outcomes of the program include increased access to and receipt of HIV testing and integrating screening services, increased access to and receipt of HIV medical care and ART for people living with HIV (both newly diagnosed and those out of care), increased access to Partner Services for people living with HIV and their partners, increased access to and receipt of essential support services (e.g., syringe services and other services available at HIV Alliance and in the community) for people living with HIV and the target at-risk population, increased access to PrEP and nPEP for the target population, increased access to condoms and other safer sex supplies and education, and increased collaboration with state and local public health departments to support HIV outbreak/cluster response. These outcomes will reduce new HIV and other sexually transmitted infections; reduce HIV-related health disparities among BIPOC and PWID; increase medication adherence, improve health outcomes, increase viral load suppression, and reduce death among people living with HIV; increase safer injection practices among PWID to reduce their risk of acquiring and transmitting HIV; increased health department and community engagement for cluster detection and response; and improved response to HIV transmission clusters and outbreaks.