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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3245.0: Monday, December 12, 2005 - Board 3

Abstract #100828

Social and political predictors associated with the presence of syringe exchange programs in 96 metropolitan areas in the US

Barbara Tempalski, MA, MPH, Center for Drug Use and HIV Research, National Development and Research Institutes, 71 West 23d Street, New York, NY 10010, 212 845 4474, tempalski@ndri.org, Peter L. Flom, PhD, Institute for AIDS Research, National Development & Research Institutes, Inc, 71 West 23rd St., 8th floor, New York, NY 10010, Samuel R. Friedman, PhD, Institute for AIDS Research, National Development and Research Institutes, 71 West 23d Street, 8th floor, New York, NY 10010, Don C. Des Jarlais, PhD, Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, 1st Avenue and 16th Street, New York, NY 10003, Courtney McKnight, MPH, Chemical Dependency Institute, Beth Israel Medical Center, 215 Park Avenue South, New York, NY 10003, Risa Friedman, MPH, Center for Drug Use and HIV Research, National Development & Research Institutes, 71 West 23rd St, New York, NY 10010, and Judith J. Friedman, PhD, Department of Sociology, Rutgers University, 54 Joyce Kilmer Ave, Piscataway, NJ 08854.

Background: Community activists often initiate responses to health crises and their efforts can be important in shaping public health policies. The formation of syringe exchange programs (SEPs) in the U.S. illustrates this, as the political pressure and/or direct action of grassroots activists has been central to their formation. Other activists resist proposed SEPs especially in communities hit hardest by injection drug use-related HIV transmission. This research explores why SEPs are present in some localities but not others. Methods: We hypothesized that the highly fragmented geography of SEPs in the U.S. involves political, socioeconomic, and organizational characteristics of localities, characteristics that affect service needs, resources useful in forming an SEP, and local opposition. Using logit models we explore the impact of need, political factors, and metropolitan socioeconomic and organizational characteristics on SEP presence in 96 large metropolitan statistical areas. Results: Results indicate that need is not a significant predictor of having an SEP. Predictors are (a) percentage of population with college education; (b) proportion of men who have sex with men; and (c) having a local AIDS Coalition to Unleash Power (ACT UP) chapter. Conclusion: This research suggests that SEP formation is not based on relative need across localities, at least in the U.S., but may be based on the direct involvement of gay and lesbian activists in ACT UP and other organizations that help form and defend SEPs; they may also demonstrate the effects of more generalized gay political influence and concern over HIV/AIDS prevention and education.

Learning Objectives:

Keywords: Advocacy, Syringe Exchange

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Injecting Drug Use and HIV: Findings from Research and Practice

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA