Date of Defense:
December 2, 2009
Objectives: To examine the research conducted on needle exchange programs to determine if the process of providing sterile syringe exchange reduces high-risk drug behavior and increases health outcomes of program participants. The acts of sharing drug injection equipment or using dirty syringes are considered high-risk drug behaviors due to ease of transmission for blood-borne pathogens such as Human Immunodeficiency Virus (HIV) and hepatitis C
Methods: Online databases (i.e., OVID Medline, PubMed, PychInfo) were used to search for keywords in peer-reviewed journal articles published from 1994-2009. Additional articles were pulled from tracing cited journal references and by searching known needle exchange program researchers by name.
Results: Out of 163 citations identified, 31 articles were retained for review. Of the 31 articles that examined high-risk drug use behavior, 22 reported that needle exchange participation was associated with a reduction. Of the 10 studies that examined HIV and/or HCV, 6 reported that needle exchange participation was protective against disease seroconversion.
Conclusions: Needle exchange is a valuable public health strategy in reducing high-risk drug behavior and can affect disease prevalence in populations who use injection drugs. Needle exchange programs are also successful in recruiting very high-risk participants—those who are high-frequency injectors because of amphetamine use and/or are involved in commercial sex trade—making them logical locations for comprehensive prevention services.