Examining Social-Ecological Factors in Developing the Louisville Metro Department of Public Health and Wellness Syringe Exchange Program.

Amid an opioid epidemic and increasing HIV and hepatitis C virus (HCV) concerns, the Louisville Metro Department of Public Health and Wellness developed syringe exchange programming (SEP) to reduce HIV and HCV transmission, increase linkage to health care, and provide health education to clients in Louisville, Kentucky. We describe organizational, community, and policy factors contributing to SEP development. Approximately 8000 clients received SEP services from June 2015 to December 2016.