Satellite exchange in the Baltimore Needle Exchange Program

Objective. Our first objective was to develop an index of satellite exchang e and then determine whether satellite exchangers (SEs) differed demographi cally or behaviorally from other injecting drug users (IDUs). Our second ob jective was to determine the degree that SEs contributed to needle exchange program (NEP) effectiveness. Methods. We collected data from approximately 5000 Baltimore Needle Exchang e Program (BNEP) participants on the number of syringes acquired and return ed over the two-year period February 1995 to February 1997. We then conduct ed one-way ANOVAs and logistic regressions to determine if SEs were differe nt from other IDUs. Results. We classified 9.35% of the IDUs as SEs and showed that SEs reporte d levels of drug use and risk behavior similar to other BNEP participants. Although SEs represented less than 10% of all BNEP clients, they accounted for more than 64% of all needles distributed by the BNEP, We showed that SE s accessed more wide-ranging drug use networks than non-SE IDUs and thus ca n act as potential bridges for human immunodeficiency virus (HIV) preventio n materials and messages to larger numbers of drug injectors. Conclusions. SEs can be expressly targeted with specific prevention message s and encouraged to be *ambassadors" for HIV prevention messages. Efforts t o curtail the activities of SEs may detract from the effectiveness of NEPs.