Secondary Syringe Exchange Among Injection Drug Users

Abstract

Syringe-exchange programs (SEPs) have proven to prevent the spread of bloodborne pathogens, primarily human immunodeficiency virus (HIV), among injection drug users (IDUs). In the United States, only about 7% of IDUs have access to and use SEPs. Some IDUs engage in secondary syringe exchange (SSE), meaning that one IDU (a "provider") obtains syringes at an SEP to distribute to other IDUs ("recipients"). This formative qualitative research was conducted to understand why and how IDUs engage in SSE to aid in the development of a large-scale peer HIV prevention intervention. Interviews with 47 IDUs in Oakland and Richmond, California, indicated that SSE was embedded in existing social networks, which provided natural opportunities for peer education. SSE providers reported a desire to help other IDUs as their primary motivation, while recipients reported convenience as their primary reason for using SSE. Building SSE into SEP structures can facilitate an effective provision of risk reduction supplies and information to IDUs who do not access SEPs directly.

Some Data-Driven Reflections on Priorities in AIDS Network Research

“…In this model, drug injectors distribute syringes to members of their networks, and also collect used syringes from network members to return to syringe exchange sites. As Snead et al (2003) report, since secondary syringe exchange is embedded in users' social networks, this makes it easy for peer education to take place. Users who provide syringes to others reported they took part because they wanted to help other IDUs; recipients took part because it was convenient to do so.…”

Aider, s’aider, s’entraider : expériences de femmes travailleuses du sexe de rue et utilisatrices de drogues par injection dans une recherche-action participative visant la prévention du VIH

“…De fait, les personnes UDI, même marginalisées, peuvent avoir un impact important sur les façons de faire de leur groupe en faisant montre de comportements de santé (Snead et al, 2003 ;Wood et al, 2003). L'intervention par les pairs aurait de nombreux avantages tels que son faible coût, la capacité des pairs à rejoindre des consommateurs désaffiliés, leur influence « naturelle » et leur aisance à entrer en contact avec les membres de leur communauté (sur les avantages de l'approche d'intervention par les pairs, voir, entre autres, Bellot, Rivard & Greissler, 2010 ;Medley, Kennedy, O'Reilly & Sweat, 2009 ;Milburn, 1995 ;Shiner, 1999 ;Turner et Shepherd, 1999 L'expérience de la participation a été très peu documentée chez des femmes TSR-UDI impliquées dans une intervention par les pairs.…”

Social Network-Related Risk Factors for Bloodborne Virus Infections Among Injection Drug Users Receiving Syringes through Secondary Exchange

“…This practice has been called secondary syringe exchange (SSE) because it involves secondary exchangers who obtain large quantities of syringes from a sanctioned source to redistribute them to other IDUs for sale, trade, altruistic purposes, or as part of drug transactions. [8][9][10][11][12] Of the approximately 44,000 visits recorded to SEP and other syringe access sites in Montreal during 2002-2003, 15% of visits involved the distribution of sterile syringes for use by both the service attender and other IDUs, whereas in 5% of visits, the syringes were destined specifically for another IDU. 7 The high volume of syringes distributed through SSE reflects findings from other jurisdictions where SSE providers have been reported to distribute up to 60% of syringes exchanged at SEPs, although these individuals represented less than 10% of the clientele.…”