Table 1 Primary and secondary outcomes for objective 1
| Â | Definition | Measure |
|---|---|---|
Primary outcome | ||
 HIV Prevention via PrEP | Taking PrEP at 3-, 6-, 9-, and 12-month follow-up | Intracellular levels of tenofovir diphosphate (TFV-DP) by DBS or cabotegravir injection in previous 8 weeks by electronic health record abstraction |
 HIV Prevention via MOUD | Taking MOUD at 3-, 6-, 9-, and 12-month follow-up | Norbuprenorphine or methadone on UDS or naltrexone or buprenorphine extended-release injection in previous 4 weeks by electronic health record abstraction |
Secondary outcomes | ||
 Syringe coverage | Dispensing syringes to cover each injection event | Number of syringes distributed/(number of injections per day × days between exchanges) from SSP administrative data |
 PrEP Adherence | Taking PrEP at least 4 times per week | TFV-DP level of 700 fmol/punch on DBS for TDF [64]; TFV-DP level of 950 fmol/punch on DBS for TAF[65] |
 Engagement in HCV treatment | Receiving a prescription for DAA | DAA prescsiption confirmed on electronic health record abstraction |
 HCV cure (SVR 12) | Initiating HCV treatment and achieving undetectable HCV RNA PCR at least 12 weeks after completion of therapy | Negative HCV RNA PCR (viral load) at least 12 weeks post treatment completion |
 Treatment of STIs | Receiving treatment for STI after a positive screen | Prescription of appropriate antibiotics (may differ based on allergies) from electronic health record abstraction |
 Time to harm | Time to: (1) emergency department visit or hospitalization for injection-related infection or overdose; (2) incident HIV infection; (3) incident HCV infection; or (4) death from overdose | (1) Electronic health record abstraction; (2, 3) IDEA test results; (4) electronic health record abstraction or medical examiner database |
 Number of harms | Count of (1) emergency department visit or hospitalization for injection-related infection or overdose; (2) incident HIV infection; (3) incident HCV infection; or (4) death from overdose | (1) Electronic health record abstraction; (2, 3) IDEA test results (4) electronic health record abstraction or medical examiner database |