C. Sears et al., Investigation of a secondary syringe exchange program for homeless young adult injection drug users in San Francisco, California, USA, J ACQ IMM D, 27(2), 2001, pp. 193-201
This study investigated an HIV prevention program for homeless young adult
injection drug users (IDUs) that combined a secondary syringe exchange prog
ram (SEP) with community-level activities. Homeless young IDUs were recruit
ed from street-based settings in San Francisco, and a structured questionna
ire was administered. The secondary SEP operated in a circumscribed geograp
hic area, and for analytic purposes respondents were assigned to the interv
ention site group if they primarily spent time in this area (n = 67), or th
e comparison site group if they primarily spent time elsewhere(n = 55). Alm
ost all (96%) intervention site youth had used the secondary SEP in the pas
t 30 days and were significantly more likely to regularly use SEP. In bivar
iate analysis, comparison site IDUs were more likely to share syringes, reu
se syringes, share the cotton used to filter drugs, and use condoms with ca
sual sex partners only inconsistently. In multivariate analysis, comparison
site remained positively associated with sharing syringes (adjusted odds r
atio [AOR], 3.748; 95% confidence interval [CI], 1.406-9.988), reusing syri
nges (AOR, 2.769; 95% CI,1.120-6.847), and inconsistent condom use with cas
ual sex partners (AOR, 4.825; 95% CI, 1.392- 16.721). This suggests that th
e intervention was effective in delivering SEP services to homeless young a
dult IDUs, and that IDUs who frequented the intervention site had a lower H
IV risk than comparison group IDUs.