July 14, 2005

US needle exchange programs declining

NEW YORK (Reuters Health) - Some needle exchange programs
in the US have ceased operations in recent years, and public
funding for these programs has declined, according to a report
released today.

Needle exchange programs help prevent transmission of HIV
and other bloodborne infections by increasing access to sterile
syringes among injection drug users (IDUs) and safely disposing
of used syringes. Exchange programs also offer social services,
such as provision of condoms, referrals for substance-abuse
treatment, and testing for HIV and hepatitis.

In 2003, Dr. C. A. McKnight, from New York's Beth Israel
Medical Center, and colleagues conducted surveys among 148
exchange programs known to the North American Syringe Exchange

"In 2002, for the first time in 8 years, the number of
exchange programs, the number of localities with exchange
programs, and the amount of public funding for exchange
programs in the United States decreased," the authors note in
the Morbidity and Mortality Weekly Report, a publication of the
Atlanta-based US Centers for Disease Control and Prevention.

Specifically, the number of needle exchange programs
declined from 154 to 148 from 2000 to 2002, primarily through
loss of small programs, while the number of states and
territories with exchange programs fell from 35 to 32. Public
funding decreased 18 percent.

At the same time, the number of syringes exchanged
increased 20.2 percent and total budgets increased 7.4 percent.

Such programs "provide health and social services to IDUs
who might not otherwise be reached," the authors conclude.
"Continued monitoring of exchange programs in the United States
is necessary to evaluate the long-term effects of this public
health intervention."

SOURCE: Morbidity and Mortality Weekly Report, July 15,