Needle exchange program attendance and injection risk in Providence, RhodeIsland

Needle sharing has long been recognized as a primary route of HIV infection . However, recent research has shown that HIV antibody is also detectable i n injection supplies other than needles. In this study we tested frequency of attendance at a Providence, Rhode Island, needle exchange program (NEP) as a correlate of injection risk indicators including not just sharing need les but also sharing cookers, sharing cotton filters, cleaning the skin bef ore injecting, and using bleach as a needle disinfectant. Results showed th at drug users who attended the NEP less frequently were more likely to repo rt needle sharing, less likely to report always cleaning their skin, and mo re likely to report sharing cookers. The Providence NEP is one at which alc ohol swabs and cookers are distributed along with clean needles. Our result s suggest that NEPs represent a valuable and underexploited opportunity to promote risk reduction efforts beyond the avoidance of needle sharing. NEPs should be distributing risk reduction supplies in addition to clean needle s and should adopt strategies (e.g., outreach and more days/hours of operat ion) to encourage frequent attendance.