Evaluating needle exchange: do distributed needles come back?

Guydish, Joseph; Clark, George L.; Garcia, Delia; Downing, Moher; Case, Patricia; Sorensen, James L.

doi:10.2105/ajph.81.5.617

Cited by 19 publications

(12 citation statements)

References 4 publications

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“…Four investigations [24,25,28,29] employed some sort of needle tracking system in order to determine length of time a needle was in circulation and/or to test a sample of the needles returned for the presence of HIV. Table 1 presents a complete listing of the studies providing return rate data.…”

Section: Resultsmentioning

confidence: 99%

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Ksobiech

2004

Harm Reduct J

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This study searched the available needle exchange program (NEP) literature for return rate data. A total of 26 articles were found. The overall worldwide return rate was 90%, although this ranged from a low of 15% to a high of 112%. U.S. NEP return rates were gathered from only eight studies, indicating a clear need for more data, although U.S. return rates were comparable to those from NEPs outside of the U.S.One underlying assumption made by opponents of NEPs is that IDUs will not return needles to the distribution site, thereby potentially increasing the risk of health problems to the surrounding community from exposure to contaminated needles. This study's results suggest that NEPs are relatively successful in taking in used needles, although it is generally unclear where the needles were originally acquired, and if IDUs return their own needles, or are returning needles for a social network. Ways for AIDS Service Organizations to capitalize on these brief encounters with IDUs, as well as public policy implications of the findings, are discussed.

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Section: Resultsmentioning

confidence: 99%

“…Return rate data may provide useful evidence of NEP effectiveness in reducing needle-sharing behaviors among NEP attenders, without relying on IDU self-reports [24]. Robles et al [25] opine that the number of syringes exchanged can be used as an outcome measure of NEP effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Ksobiech

2004

Harm Reduct J

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“…Many studies examined NEPs that provide needles at both fixed and roving sites, but the results were usually combined. It's possible, as suggested by Guydish et al [35], that roving NEP attracts a different IDU population than fixed sites. Data need to be gathered to explore that possibility.…”

Section: Differences In Types Of Nepsmentioning

confidence: 99%

Untitled

Ksobiech

2004

Harm Reduct J

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Based on an extensive review of the needle exchange program (NEP) literature, the author sought to identify weaknesses in NEP evaluations published to date. Surprisingly, it was apparent that NEP researchers often fail to: (1) collect comparison/change data; (2) agree on appropriate and consistent dependent variables to measure; (3) use valid and reliable measurement instruments; (4) present clear operational definitions; (5) analyze outcome measures by gender/race/social context; (6) provide data on type of drug injected as it relates to risky drug and sexual behaviors; (7) measure HIV/AIDS knowledge; or, (8) clearly articulate desired NEP outcomes. Suggestions for future research are included, and conclusions about the overall state of NEP evaluative research are drawn.

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“…While these differences may impact a particular program's effectiveness, SEPs have been found to have a positive overall impact on harm reduction and HIV prevention (Vlahov and Junge 1998;Hurley et al 1997;Heimer 1998;Archibald et al 1998;Singer 1997;Des Jaríais et al 1996;Page 1997;Heimer et al 1996;Heimer et al 1993;Normand et al 1995;Guydish et al 1991;Groseclose et al 1995;Watters et al 1994;Heimer et al 1994;Lune et al 1993). In addition to providing sterile syringes and other drug equipment, many SEPs offer a range of services, including information on safer injection practices and referrals to health care and treatment programs.…”

Section: Impact Of Syringe Exchange Programs 417mentioning

confidence: 99%