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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3245.0: Monday, December 12, 2005 - Board 6

Abstract #116354

Are syringe exchange programs (SEPs) giving out enough syringes to lower HIV risk? Examining the association between distributed syringes, injection frequencies and HIV risk among clients of California SEPs

Ricky N. Bluthenthal, PhD1, Lauren Gee2, Mary Lou Gilbert, JD, MA1, Rachel Anderson, BA3, Neil Flynn, MD, MPH3, Andrea Scott4, and Alexander H. Kral, PhD5. (1) RAND Health, RAND, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407, 310-393-0411 x6642, rickyb@rand.org, (2) Urban Health Study, University of California, San Francisco, 3180 18th St., Suite 302, San Francisco, CA 94110, (3) Infectious Diseases, UC Davis, 4150 V St., Suite 500, Sacramento, CA 95817, (4) Urban Health Studies, UCSF, 3180 18th St. Suite 302, Campus box 1304, San Francisco, CA 94110, (5) Urban Health Study, Dept. of Family and Community Medicine, University of California, San Francisco, 3180 18th St. Suite 302, Campus box 1304, San Francisco, CA 94110

Objectives: To estimate the percentage of syringe coverage (number of syringes received on a monthly basis from SEPs divided by number of monthly injections) and to determine whether higher syringe coverage is associated with lower HIV risk. Methods: Risk behavior assessments were conducted with clients from 24 California SEPs between 2001 and 2003 (n=1566). Syringe coverage was measured by number of syringes received on a monthly basis from SEPs divided by number of monthly injections. Client syringe coverage was grouped into three categories: <50% coverage, 50-99% coverage, and 100% + coverage. Results: 47% of SEP clients had 100%+ syringe coverage, 19% between 50-99%, and 34% had <50% coverage. In multivariate analyses controlling for individual and program-level variables, 100%+ coverage was protective against syringe reuse (AOR=0.75; 95% CI=0.71, 0.79), receptive syringe sharing (AOR=0.81; 95% CI=0.77, 0.85), distributive syringe sharing (AOR=0.81; 95% CI=0.78, 0.85), and sharing cookers (AOR=0.89; 95% CI=0.85, 0.94) as compared to IDU reporting <50% coverage. 50-99% coverage was protective against syringe re-use (AOR=0.89; 95% CI=0.83, 0.96), receptive syringe sharing (AOR=0.92; 95% CI=0.86, 0.99), and distributive syringe sharing (AOR=0.88; 95% CI=0.83, 0.93). Conclusions: Syringe coverage measures can help SEPs determine whether their clients are receiving sufficient syringes to lower their HIV risk.

Learning Objectives: At the conclusion of this session, participants will learn

Keywords: Needle Exchange Programs, Infectious Diseases

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Injecting Drug Use and HIV: Findings from Research and Practice

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA