The past decade has seen the development of needle exchange programs in many areas of the United States to combat the spread of HIV/AIDS and hepatitis among injection drug users. Although many models of service provision exist for needle exchange, much of the literature has focused on street-based service delivery models, either in evaluating the effectiveness of needle exchange services or in describing the characteristics of the recipients of services. There is strong empirical evidence to support the effectiveness of these programs with regard to decreased HIV infection rates, decreased needle sharing, and improved needle hygeine. Needle exchanges have also been shown to serve as a conduit for abstinence based drug treatment for program participants. Needle exchange programs have also been shown to be cost effective. The next logical step for research in this area should be the systematic description and comparison of alternative models of needle exchange delivery. This presentation will describe the history, development, implementation, and specific program components of needle exchange models implemented in three greatly differing metropolitan areas: Nashville, Cleveland, and Los Angeles. All models originated with street-based delivery and evolved respectively into a secondary exchange model (Nashville) and two differing models involving drop-in centers providing ancillary services (Cleveland and Los Angeles). Programs will be compared and contrasted on demographic and psychosocial characteristics of service users. Issues of matching service users needs and service delivery models will be discussed, with particular attention paid to cultural and political environmental factors impacting the development of each model.
Learning Objectives: Develop an understanding of three very different service delivery models for needle exchange programs. Articulate comparisons and contrasts between these three models. Develop an understanding for the need to take environmental factors (cultural and political)into the selection of appropriate service delivery models
Keywords: Injection Drug Users, Needle Exchange Programs
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Xchange Point, Cleveland, OH, Davidson County Harm Reduction Program, Nashville, TN,
Clean Needles Now, Hollywood, CA
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.