Project Summary People who inject drugs (PWID) are at exceedingly high risk of HIV compared to the general population, yet pre-exposure prophylaxis (PrEP) programs that target them in the U.S. are scarce and accordingly PrEP uptake in this population remains low. In recent years, substance use services have been scaled up to address overdose among PWID, however, they remain an underutilized entry point into PrEP. Yet, research has documented an increase in HIV risk behaviors (e.g., syringe sharing, high injection frequency) with the rise of illicit fentanyl in the U.S., underscoring the need for increased PrEP use among PWID. Further, in the last several years, xylazine, an animal tranquilizer, has penetrated the illicit opioid market in many cities including Baltimore. Xylazine use significantly elevates the risk of experiencing nonfatal and fatal overdoses among opioid users, as has been documented in Baltimore and elsewhere. Xylazine use causes skin and soft tissue infections (SSTIs) among PWID. Many SSTIs can be resolved through basic wound care (e.g., cleaning and dressing), but if unattended, infections often escalate to more serious conditions (e.g., infective endocarditis, bacteremia) which can result in hospitalizations, amputation, or death. The receipt of necessary medical services is often hindered by persistent barriers to accessing traditional healthcare settings (e.g., cost, transportation, stigma). We propose adding wound care services to the Check it intervention in order to respond to the increasing burden of xylazine-associated of SSTIs. The impact of Check it on PrEP uptake and outdoes outcomes is measured by a longitudinal cohort study (“SCOPE”) of street-recruited PWID (N=500), is evaluating the impact of Check It on PrEP continuum engagement and overdose outcomes. Housed in a mobile van, Check It provides pre-exposure prophylaxis (PrEP) delivered by a nurse and supported by peer navigators, and point-of-care (POC) drug checking using a Fourier Transform Infrared Spectrometer (FTIR) that detects the relative quantity and diversity of substances in a given sample. We propose adding wound care services to further meet the urgent needs of PWID as well as promote and engage PWID in accessible, low barrier, PrEP services.