Objective: To assess over time the injection-related HIV risk practices of participants in a syringe exchange program (SEP). Methods: Between 1996-1999, 639 participants in a syringe exchange program (SEP) in Chicago were interviewed regarding HIV risk practices and counseled and tested for HIV. These data were again collected approximately one year after baseline. Using McNemar’s chi-square tests, we compare injection-related HIV risk practices reported at baseline and follow-up for SEP users who completed both interviews and who continued to inject drugs after baseline. Results: The sample is 42% African-American, 21% Latino and 35% White, 29% are women, and the median age is 42 years. HIV prevalence at baseline was 16%. Interviews were conducted with 77% (n=394) of SEP users due for one-year post-baseline data collection. SEP users reported significant and sizeable reductions in syringe-related risk practices, including passing used syringes to others (48% at baseline vs. 28% at follow-up, p=.00) receptive multiperson syringe use (41% vs. 28%, p=.00), and syringe-mediated sharing, principally backloading (24% vs. 11%, p=.00). Statistically significant reductions of smaller magnitudes were reported for the multiperson use of other injection paraphernalia and reuse of one’s own syringe. Five HIV seroconversions were observed during 302 person-years of risk (PYR), for an HIV incidence of 1.66/100 PYR. Discussion: HIV risk practices, particularly the sharing of syringes, appear to have declined among SEP participants during 12 months of observation. The low rate of incident HIV infection supports the validity of these self-reports.
Learning Objectives: At the presentation’s conclusion, participants should be better equipped to discuss the impact of syringe exchange programs on HIV risk and assess certain methodological difficulties in evaluating SEPs that may lead to an underestimation of the impact of SEP on risk reduction
Keywords: Needle Exchange Programs, HIV Risk Behavior
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: The School of Public Health, University of Illinois at Chicago, through linkage agreements with two community-based organizations, participates in the provision of the needle exchange program services that this study assesses. I am on the faculty of the