228090 Current State of Syringe Exchange Programs in the US: Crisis and Opportunity

Tuesday, November 9, 2010 : 9:30 AM - 9:45 AM

Don C. Des Jarlais, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Vivian Guardino, BA , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Kamyar Arasteh, PhD , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Courtney McKnight, MPH , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
Judith Milliken, BA , Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY
David Purchase , North American Syringe Exchange Network, Tacoma, WA
Background: Syringe exchange programs began in the US in the late 1980s and there are presently approximately 180 active syringe exchange programs (SEPs). During this time period, HIV incidence among IDUs declined by 80%. The ban on federal funding for syringe exchange was recently removed, but programs may be facing severe budget cuts due to fiscal problems among state and local governments.

Methods: A survey of executive directors of US syringe exchange programs participating in the North American Syringe Exchange Network (NASEN) was conducted in Spring, 2009. The questionnaire asked about program operations in 2008 and was emailed with follow-up telephone interviews. Similar surveys have been conducted since 1994, and a survey is currently being conducted for 2009 program operations. Data from the current survey will be included.

Results: 123 of 180 programs provided data for 2008. SEPs were active in 98 cities in 30 states. 29.1 million syringes were exchanged, and total SEP budgets totaled $21.2 millon, of which $16.8 (79%) was from local and state governments. SEPs provided many services in addition to basic syringe exchange: 98% provided male condoms, 87% HIV testing, 65% HCV testing, 55% STI screening, 49% HBV vaccination, and 89% referrals to substance abuse treatment.

Conclusions: US SEPs have become multi-service organizations heavily dependent upon state/local government funding. The 2008 data provides a baseline and the 2009 data will provide a first assessment of state/local budget reductions and how SEPs expect to use any federal funds that become available.

Learning Areas:
Epidemiology
Implementation of health education strategies, interventions and programs
Public health or related public policy

Learning Objectives:
1.Discuss the role of syringe exchange programs in US HIV prevention. 2.Identify syringe exchange programs as multi-service organizations. 3.Discuss current funding situation of US syringe exchange programs.

Keywords: Syringe Exchange, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have been working with syringe exchange programming and IDUs since the 1980s when HIV first became apparent.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.