- Issues ? Efficacy?
- Political controversy.
- Other countries.
- Understanding and working with misusers ? Compliance.
- Results and limitations.
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
[...] 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. [...]
[...] The research findings included the following: the needle exchange program dispensed 8,950 syringes monthly and 6,918 were returned monthly, an average monthly return rate of for the subsample, there was a significant decrease in injection frequency between Time 1 and Time 2 interviews; and compliance with syringe return was high and significantly improved during the one year evaluation period of the study. Understanding and working with misusers Compliance Even two decades into the AIDS crisis, much of the popular conception of AIDS revolves around the idea of risk groups - this is especially so after a decade and a half of education oriented toward young people, gays, and white Americans. [...]
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