R. Heimer et al., NEEDLE EXCHANGE DECREASES THE PREVALENCE OF HIV-1 PROVIRAL DNA IN RETURNED SYRINGES IN NEW-HAVEN, CONNECTICUT, The American journal of medicine, 95(2), 1993, pp. 214-220
PuRPosE: To report on the deployment of the syringe tracking and testi
ng system in the New Haven needle exchange program, which is the first
federally funded evaluation of a needle exchange program conducted in
the United States. PATIENTS AND METHODS: A legal needle exchange for
intravenous drug users began in New Haven, Connecticut, in November 19
90. All syringes distributed by the program received unique tracking c
odes. Syringes were tracked and HIV-1 proviral DNA prevalence in retur
ned syringes was assessed using polymerase chain reaction and Southern
blotting. RESULTS. At the outset of the program, the prevalence of HI
V-1 proviral DNA in syringes exceeded two thirds. Prevalence decreased
rapidly to less than 45% during the first 3 months of the program and
remained at this level for the following 10 months. During the period
s of decreasing prevalence and subsequent steady state, no changes in
the demographics of program participants or in the drug use habits of
newly enrolling clients that could account for the decrease in HIV-1 p
revalence in needles were detected. In addition, the program referred
almost 20% of its clients to drug treatment programs. CONCLUSION: The
needle exchange program in New Haven has decreased the percentage of s
yringes testing positive for HIV-1 proviral DNA among needle exchange
clients while simultaneously serving as an entry point for drug treatm
ent.