HIV prevalence remains low among Calgary's needle exchange program participants

Harm reduction approaches such as needle exchange programs have been promot ed as important components of HIV prevention strategies for injection drug users (IDU).(1) Needle exchange programs (NEP) have been operating in many Canadian cities since the late 1980s. In Calgary, the NEP has been active s ince 1990. There were 1,800 individual clients registered with the NEP betw een January 1995 and December 1997 and 416,000 syringes were exchanged in 1 998, with numbers increasing annually.(2) At the time of this study, traine d nurses at one clinic site and one mobile van provided counselling, primar y health care and vaccinations, conclusions doms and referral services in a ddition to sterile syringes. An estimate of the number of IDU in Calgary in 1996 was 3,540.(3) This estimate is likely to be conservative, and it is n ot known what proportion of these individuals use the NEP. The only survey thus far of HIV prevalence and behaviour characteristics am ong IDU in Calgary took place in 1992, when prevalence was estimated at 2.2 % among a sample of 103 clients of the NEP who volunteered to participate i n a one-hour survey.(4) Data from other Canadian cities suggest that increa ses in incidence and prevalence have occurred among IDU since the epidemic began, and that high-risk behaviours have remained common.(5,6).