We employed capture-recapture methods as a strategy for evaluating needle exchange. Needles distributed by the exchange at two time periods were marked with color coded bands indicating the date and site of distribution. Half of the marked needles (2,068/4,239) returned within two weeks of distribution, and 61 percent (2,593/4,239) returned during the study period. The rate of return for stationary exchange sites (63 percent) was greater than that for roving/mobile sites (51 percent; chi 2 = 28.6, p less than .001). Of all needles returned, 87 percent (2,248/2,593) returned to the site of original distribution.
This paper describes the demographic and drug use characteristics, and levels of HIV-related risk behavior, for a sample of injection drug users (N=50) participating in the San Francisco needle exchange program. Exchange patrons were recruited as they approached the street-based exchange program, and were interviewed immediately to minimize drop-out. Clients reported high levels of satisfaction with exchange services, and many reported decreasing HIV risk behavior since participating in the exchange. Regular participation in the exchange was associated with lower levels of HIV risk behavior, but number of months since first visiting the exchange was not. Participation in needle exchange may negatively impact drug use behavior for a small minority of clients, and this issue warrants further study.
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