Utilization of New York State Syringe Exchange Programs: 1992-2006

Background

Nearly 50% of cumulative AIDS cases are attributed to injection drug use (IDU) in New York State (NYS), and 90% of Hepatitis C cases have a lifetime history of IDU. There are an estimated 170,000 active IDUs in NYS. Syringe exchange programs (SEPs) have been credited with reducing HIV transmission in NYS, however the utilization patterns of SEP participants in NYS have not been fully explored.

Methods

Enrollment and transaction-level data from every SEP operating in NYS from 1992 through 2006 were analyzed. Analyses were standardized by using one year of data on each participant, commencing with the date of initial enrollment.

Results

Over 110,000 participants made approximately 500,000 visits in the year following enrollment. SEP participants were primarily male (75.0%), minority (72%), over the age of 30 (80%), and New York City residents (89%). Nearly half (48.9%) returned at least once to the same SEP, with similar return rates over the 14-year period. Returning SEP clients made a mean of 8 visits and received a mean of 24 needles per visit. Less than 5% of SEP users accounted for over 50% of total utilization. 75% needles distributed were returned. The largest differences in utilization were observed between individual SEPs.

Conclusions

Over 110,000 IDUs utilized NYS SEPs since their legalization in 1992, with highest utilization limited to a subset of IDU. SEP Utilization patterns, coupled with the limited number of SEPs operating in NYS, illustrates the importance of increasing access to sterile needles through additional venues in NYS.