Background: Needle Exchange Program (NEPs) often report low return rates (approximately 50%) among new registrants. Attrition can adversely affect transmission of HIV and other blood-borne diseases while limiting opportunities to refer clients to drug treatment and other services. Objective: To identify factors associated with attrition from NEPs. Methods: Between 5/98 and 5/99, participants who enrolled in the Baltimore NEP completed registration surveys on sociodemographics and risk behaviors. For a subsample, primary residences were mapped with Geographic Information System software (Arcview) and distances to nearest NEP sites were calculated. Bivariate logistic regression was used to compare those who returned versus those who did not return six months post-enrollment. Results: Of 1,616 registrants, 64% were male, 64% were African American and median number of daily injections was 4. NEP return rate was 70%. Relative to those who returned, clients not returning did not significantly differ in gender, race, education or employment (p>0.05). Compared to clients reporting stable housing, those reporting unstable housing were half as likely to return to NEP (OR=0.45; p=0.01). Among geocoded records (n=201), clients residing >2 miles from NEP were marginally less likely to return compared to those residing <2 miles from NEPs (OR=0.5; p=0.07). Conclusions: These data suggest that unstable housing can limit the extent to which IDUs maintain contact with NEPs. Intensified efforts should focus on increasing public attention on housing issues and re-engaging drug users with NEPs. This study also suggests that GIS may be a helpful tool for identifying structural impediments to health care utilization.
Learning Objectives: At the conclusion of this session participants will be able to identify and describe factors associated with attrition from NEPs
Keywords: HIV/AIDS, Needle Exchange Programs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA