SYRINGE USE AND REUSE - EFFECTS OF SYRINGE EXCHANGE PROGRAMS IN 4 CITIES

We determined the effect of syringe exchange programs (SEPs) on syring e reuse patterns. Five methods were employed to estimate injections pe r syringe made by exchange clients in four cities. In San Francisco, C hicago, and Baltimore, self-reported data on the number of injections per syringe were obtained. In New Haven, self-reported injection frequ encies were combined with syringe tracking data to derive two methods for estimating the mean injections per syringe. The average number of injections per syringe declined by at least half after establishment o f SEPs in New Haven, Baltimore, and Chicago, all cities where such an analysis could be made. There were significant increases in the percen tages of exchangers reporting once-only use of their syringes in San F rancisco, Baltimore, and Chicago, all cities where the data were amena ble to this form of analysis. Self-report and syringe tracking estimat es were in agreement that SEP participation was associated with decrea ses in syringe reuse by drug injectors. SEP participation was associat ed with increases in the once-only use of syringes. These findings add to earlier studies supporting the role of SEPs in reducing the transm ission of syringe-borne infections such as HIV and hepatitis.