NEW NEEDLE AND SYRINGE USE, AND USE OF NEEDLE EXCHANGE PROGRAMS BY STREET RECRUITED INJECTION-DRUG USERS IN 1993

Background Needle exchange programmes (NEP) provide injection drug use rs (IDU) with sterile injection equipment and receive used needles in exchange. In this paper we describe the use of new syringes and NEP by IDU and characteristics associated with using NEP in 1993. Methods St reet-recruited IDU were interviewed in five US locations: Atlanta, Phi ladelphia, Chicago, New York City, and Los Angeles (LA) county. Result s Most (75-95%) reported it was easy to get a new syringe and for thei r last injection, 45-77% used a new syringe and 2-18% used a syringe p reviously used by another IDU. Use of NEP ranged from 8% to 16% in Chi cago, Philadelphia, and LA County. In LA County not having injected 's peedball' in the last 30 days, last injection with a new syringe, and reporting it was very easy to get a new syringe were associated with N EP use. In Philadelphia, NEP use was associated with 'speedball' injec tion in the last 30 days, and in Chicago, not injecting with 'speedbal l' and injecting with cocaine were associated with NEP use. Conclusion s In 1993, most street-recruited IDU in Chicago, Philadelphia, and LA County had not used NEP. Factors associated with NEP use were not cons istent across sites. Dispersion of NEP and removal of legal barriers r estricting access to sterile syringes may be more important in increas ing the use of sterile syringes and NEP than client characteristics.