“…In the late 1980s, a ban prevented the use of federal funding to support SSPs, and it was renewed each year through a law called the Public Health and Welfare Act until it was overturned by Congress in 2009 (Armstrong-Mensah, Dada, Rupasinghe, & Whately, 2021). Many states filled the gap by funding SSPs at the state and local level (Des Jarlais, 2004); however, local laws and enforcement practices created additional barriers which hindered implementation of SSPs (Polomarkakis, 2017) and harm reduction across the country (Green, Martin, Bowman, Mann, & Beletsky, 2012). For reasons such as the rise in HIV cases in rural communities due to needle sharing among people who inject drugs (Weinmeyer, 2016), the federal ban was partially lifted in 2015 to allow federal funds to support all SSP activities, except for the purchase of clean injection supplies (Showalter, 2018).…”