L.A. County Paused Syringe Handouts in Skid Row as HIV Cluster Grew

Los Angeles County has stopped handing out syringes and smoking pipes at its flagship Skid Row services campus and, on Tuesday, ended its contract with the nonprofit that ran harm reduction programs there. The pause at the Skid Row Care Campus began in August, the county Department of Health Services confirmed to LAist, and officials say they have not set a date for it to resume.

The department described the pause as temporary and attributed it in part to complaints from nearby businesses and community stakeholders. The contract termination with Homeless Health Care Los Angeles, which has worked in the neighborhood since the 1980s, takes effect the same week the nonprofit's state-notified layoffs of 134 workers — 117 of them at the campus — became permanent.

The timing is what critics have seized on. Los Angeles County public health officials identified a cluster of HIV cases among people living in and around Skid Row in late August. As of Sunday, 15 people had been linked to it, 11 of them women, according to department spokesperson Becky Schlikerman. The department says both substance use and sexual transmission are being investigated as possible routes, and that it is working with street medicine teams and harm reduction groups to expand testing and prevention in the area.

What the county stopped handing out, and what it still does

The campus continues to distribute naloxone, wound care supplies and safe sex supplies, health services spokesperson Thomas Lynch said. Syringes and pipes are the pieces that stopped.

Lynch said the pause applies only at the Care Campus, that staff are referring people to syringe programs elsewhere in the county, and that no restart date exists. According to the California Department of Public Health, 24 authorized syringe services programs operate in Los Angeles County; two are based in or immediately next to Skid Row.

County officials framed the contractor change as an operational matter rather than a policy reversal. In statements to LAist, the departments of health services and homelessness said they were "strengthening operations," updating campus protocols, "strengthening on-site safety," and expanding substance use treatment and health care on site.

Providers replaced, and a workforce absorbed

The county is bringing in St. Joseph Center and LA Community Health Project, while Social Model Recovery Systems expands existing services and Wesley Health Centers continues providing care at the campus. Officials said the incoming providers have hired more than 80 people, nearly 90% of whom previously worked for Homeless Health Care Los Angeles.

Homeless Health Care Los Angeles marked its 40th anniversary this year. In a social media post in late September, the organization said it was "being forced to say goodbye to some deeply valued staff and reduce services that some of LA's most marginalized rely on every day," and that its jobs program for Skid Row residents "no longer exists." The nonprofit did not respond to repeated interview requests from LAist.

The HIV cluster that is still being counted

The outbreak numbers remain small and fluid, and public health officials have not characterized how the cluster is spreading. That has not softened the argument from researchers who study the neighborhood's drug supply.

"There is an active HIV outbreak in Skid Row, so reducing safe injection supplies to people who use drugs in this moment seems particularly dangerous," said Ricky Bluthenthal, a distinguished professor of population and public health sciences at USC's Keck School of Medicine. Bluthenthal co-authored a 2025 study finding that people who use fentanyl in Los Angeles have increasingly shifted from injecting the drug to smoking it — which makes pipe distribution, the other half of the pause, relevant to the same question.

He called the pause "obviously a setback," adding that harm reduction programs "through providing social and material support, have been one of the most consistent pathways to treatment for people who are currently using illicitly purchased drugs."

The county's own health services department, in a statement on the pause, said people who receive syringe services are three times as likely to reduce or stop using drugs and five times as likely to enter substance use treatment.

Where the neighborhood splits

Not everyone in Skid Row reads the handouts the same way. John Raphling of the Los Angeles Community Action Network said his group is "extremely concerned that the county is cutting these services" and that residents "were not at all consulted."

Don Garza, who has lived in the neighborhood for 27 years, told LAist he sees the supplies as harmful. "It's not helping anyone," he said. "It exponentially accelerates the overdose deaths." Garza drew a line the county has not drawn: "The part of harm reduction that we still need is the overdose prevention, but without the pipes and the needles. We still need the Narcan, because Skid Row is not going anywhere, and people are still gonna OD, and they're gonna die."

A group of residents and laid-off campus workers organized as the Skid Row Coalition for Community Safety has launched a campaign accusing the county of "playing politics with people's lives."

County Supervisor Hilda Solis, who represents the area and authored the 2022 motion that created the Skid Row Action Plan, said the decision to end the contract was made jointly by the health services and homelessness departments. "Some services have been paused to allow the incoming provider to onboard staff and establish operations," she said. "This is a necessary part of coordinating the transition." Solis, who leaves the board next month and was on Tuesday's ballot for California's 38th Congressional District, said her commitment to expanding low-barrier services and health care "remains unchanged."

The pressure behind the change is not only local. The county has faced mounting criticism from the Trump administration and from businesses near Skid Row over programs that distribute drug paraphernalia, with opponents arguing the supplies enable addiction and draw crime to the area. Supporters of the programs point to three decades of local operation — syringe exchange was authorized in Los Angeles under a county public health emergency declared in 2000 — and to the treatment referrals that come with them.

For people in the neighborhood who want medication for opioid use disorder, buprenorphine and methadone remain available through clinics and opioid treatment programs across the county, and naloxone is still distributed at the campus even as the syringe supply is paused. What has changed, for now, is where a person who injects can get clean equipment in the heart of the neighborhood.