Obstacles to needle exchange participation in Rhode Island

Objective: This study explores obstacles to participation in needle exchang e programs (NEPs) among injection drug users (IDUs) in the state of Rhode I sland, U.S.A. Methods: A written questionnaire was administered at two Rhode Island drug detoxification sites in 1998. Results: 4X8 self-administered surveys were completed, 226 (46.3%) responde nts had injected drugs in the past 6 months. 62.1% reported sharing syringe s in the past 6 months, and each syringe was used a mean of 10.7 times. Maj or obstacles to NEP participation were a lack of awareness of the program ( 25.6%), inconvenient location or hours (15.9%), and fear of identification andlor police harassment (12.2%). Nonwhite race was a significant predictor of being unaware of the NEP (p = .01) and not participating in the NEP (p = .03). 13.1% of IDUs who used the NEP were referred to the detoxification program by the NEP. Among all IDUs surveyed, 51.0% had participated in a NE P. Conclusions: NEPs are important in reducing the spread of bloodborne pathog ens among IDUs and are effective referral sources for drug treatment. Surve ys of IDUs at sites other than NEPs, such as detoxification facilities, can identify obstacles to the use of NEPs.