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Learning Objectives for this Presentation:
1.Understand the history of syringe exchange programming in the US and in other industrialized countries.
2. Understand the effectiveness of syringe exchange in preventing HIV infection among injecting drug users.
3.Understand recent developments in syringe exchange programs focused on HBV and HCV.
Background:
Syringe exchange programs have become one of the most important methods for addressing the HIV epidemic among injecting drug users (IDUs) in industrialized countries. An understanding of their historical development will be useful in considering how they should be adapted to address problems of HBV and HCV among injecting drug users.
Methods:
Review of historical documents , including scientific research studies, reports from the National Academy of Sciences, the National AIDS Commission, and the 1994-2004 bi-annual nation surveys of US syringe exchange programs.
Results:
Syringe exchange was initiated in Amsterdam in 1984 to address the problem of HBV among IDUs. Following the development of the HIV antibody test, syringe exchange was quickly adapted to address HIV in the Netherlands, United Kingdom and Australia. Syringe exchange programs began in the US in 1987-8, and have expanded to approximately 180 programs currently. With success in reducing HIV transmission, the programs have increasing been adding services to address HBV and HCV, including education, counseling and testing, referral to treatment, HBV vaccination, and increased distribution of clean cookers, filters and sterile water. Some forms of HBV and HCV services are now provided by the great majority of US exchanges. (Specific data on provision of different services with be presented.)
Conclusions:
Syringe exchange programs have had remarkable success in reducing HIV transmission in industrialized countries. They are often excellent sites for providing HBV and HCV services to IDUs. Excellent results have been obtained for some services (HBV vaccination), while the effectiveness of other services (HCV education, distributing cookers, filters and sterile water) remain to be determined.
See more of J3 - The Changing Role of Syringe Exchange Programs in Response to Prevention of Hepatitis
See more of The 2005 National Viral Hepatitis Prevention Conference