OPERATION RED BOX - A PILOT PROJECT OF NEEDLE AND SYRINGE DROP BOXES FOR INJECTION-DRUG USERS IN EAST BALTIMORE

We assessed the acceptability and the use of a community-based needle and syringe disposal project designed to serve injection drug users. I n June 1996, three surplus U.S. mail collection boxes were painted red and used as syringe and needle drop boxes in locations with high drug use in East Baltimore. Acceptance of the drop boxes was measured by f ocus groups of residents, drug users, and police, held before and afte r project implementation. Use was measured by weekly counts of needles recovered from the red boxes. A sample of all deposited needles was r andomly chosen for needle washing and subsequent HN antibody testing. Community impact was measured by systematic surveys of needles discard ed on public sidewalks, in areas with and areas without drop boxes. Be fore implementation, members of focus groups expressed concerns that d rop boxes could convey mixed messages to youth (e.g., seeming to condo ne drug use), might result in increased loitering, and could further c ommunity stigmatization. After project implementation, all focus group s expressed support of project expansion. In the first 10 months, 2971 needles were collected. Of 156 needles tested, 10.9% were positive fo r HIV antibody. Needle counts on the street showed no significant chan ge in red box areas compared with control areas. In this pilot project , red boxes were accepted by the community and drug users. police offi cers also used the boxes to dispose of confiscated needles. Although l imited in the number of drop boxes and follow-up time, this pilot proj ect shows promise as a community-based method of safe needle disposal.