The efficacy of Needle Exchange Program

Berry G.

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The efficacy of Needle Exchange Program

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Abstract

A review of the literature concerning the efficacy of needle exchange programs show that such programs work well in reducing rates of HIV and other infections among IV drug users. Further, such programs neither encourage addiction or increase rates of experimentation with intravenous drugs. However, such programs have not been widely adopted in the US. The issue of implementation is not budgetary but rather political; in the US such programs are seen as being "soft on drugs" and that stance is politically untenable in most parts of the country

Abstract.
Objective.
Design.
Introduction.
Issues ? Efficacy?
Political controversy.
Other countries.
Understanding and working with misusers ? Compliance.
Methodology.
Results and limitations.

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[...] Results and Limitations The efficacy of needle exchange programs in reducing HIV is generally well- founded, despite the fact that individuals with high risk factors will tend to patronize such programs. The more closely the programs are integrated into a system of public health (e.g., pharmacists versus grassroots programs) and greater efficacy the public health system has with the population as in Europe, where healthcare is generally nationalized the better the programs work. Limitations include an imperfect understanding of political decision-making in the US. [...]

[...] Needle exchange programs are essentially local in scope, as it often takes time and consistency in a location to build trust and a rapport with the local IV drug using population, many of whom may be homeless, suffering from mental illness (related to substance abuse, or not) or experiencing other health problems. Needle exchange programs are sometimes coupled with other public health interventions. The earliest program on record emerged as a private endeavor in Scotland in 1983, when a pharmacist began an exchange out of his storefront. [...]

[...] In the mid-1990s, however, the U. S. rates started to decline and now are a little lower than those for Spain, partly reflecting the fact that the epidemic started earlier in the United States and peaked earlier as well. Note that, given the long lead time between needle sharing and actual AIDS onset, the timing of the AIDS figures cannot readily be related to policy measures-except in the reverse sense that rising AIDS figures clearly stimulated new policies in many nations. [...]

[...] WORKS CITED Des Jarlais, DC & Friedman S. R. (1987). HIV infection among intravenous drug users: Epidemiology and risk reduction. AIDS, 67-76. DesJarlais, D. C., and Friedman, S. R. (2001). Strategies for preventing HIV infection among injecting drug users: Taking interventions to the people. In N. Schneiderman, M. A. Speers, J. M. Silva, H. Tomes, and J. H. Gentry (Eds. Integrating Behavioral and Social Sciences with Public Health. Washington, DC: American Psychological Association Des Jarlais DC, Perils TE, Friedman SR, Rockwell R. [...]

[...] Paper presented at the 127th Annual Meeting of the American Public Health Association, Chicago 1999 November 9-11. Diaz Buehler JW, Castro KG, Ward JW. (1993) AIDS trends among Hispanics in the United States. Am J Public Health. 83:504-9. Ellis, T. (1988). "Clean Needles Idea Is Menace to Society." USA Today, February A14 Frangakis, C., Brookmeyer, R.S., Varadhan, R., Safaeian, M., Vlahov, D., Strathdee, S.A. (2004) Methodology for Evaluating a Partially Controlled Longitudinal Treatment Using Principal Stratification, with Application to a Needle Exchange Program. [...]

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