Methods: Syringe exchange programs in six cities wre examined. In four, the programs were large and well supported; in one, the program was small and underground. Here the small exchange did permit pharmacy sales without prescriptions. Participants recruited through street outreach were eligible if they reported injection drug use during the previous 6 months, and were 18-30 years old. Participants were asked about socio-demographic factors, drug use patterns, and sources for obtaining needles and syringes.
Results: 2190 subjects were recruited. Rates of syringe exchange use in the past 6 months ranged from 14% to 83% across sites. Rates of receptive syringe sharing in the past 6 months ranged from 34% to 50%. In the four cities with large programs, the odds ratios for receptive syringe sharing by use of syringe exchange programs ranged from 0.48 to 0.88, with exchange users less likely to report receptive sharing. In the city with the small program, 19% reported using the exchange, 34% reported receptive syringe sharing, and the odds ratio was 2.0 (95% CI 1.04-3.82), with syringe exchange users more likely to report receptive sharing. Conclusions: The individual-level relationships between participation in a syringe exchange and engaging in HIV risk behavior may vary by the characteristics of the program and by the existence of alternative sources of sterile injection equipment in the community. Evaluations of syringe exchange programs should include consideration of program operating characteristics and the local context of syringe supply in order to avoid misinterpretation of the findings.
Learning Objectives: Discuss the use of syringe exchange and HIV risk behavior in different cities.
Keywords: Syringe Exchange, HIV/AIDS
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.