Syringe exchange schemes for drug users in England and Scotland

Abstract

In 1987 experimental schemes for distributing injecting equipment to intravenous drug users to help prevent the spread of the human immunodeficiency virus were started by the government. After six months the schemes were found to have been reasonably successful in attracting clients but were less successful in keeping them. It has been shown that equipment can be distributed to drug users on an exchange basis. Many of the clients who were attracted to these schemes had had no treatment or other help for their drug problems.

Health systems’ responses to 25 years of HIV in Europe: Inequities persist and challenges remain

“…Introduction of evidence-based guidelines helped improve service quality [72][73][74][75]. However, despite successes, inequities in access and service utilization persist in western Europe, particularly in relation to services provided to IDUs and commercial sex workers, despite the development of programmes aimed at broadening access [76][77][78][79]. Consequently, behavioural change in these risk groups is not optimal [80][81][82][83][84][85].…”

Politique de réduction des risques : programmes d’échange de seringues

“…Dans la plupart des études portant sur la clientèle des PES [5][6][7][8][9], les usagers de drogues ont entre 27 et 38 ans. Il s'agit dans environ trois quart des cas d'hommes, pour lesquels la durée moyenne de consommation de drogues illicites varie entre 7 et 11 ans.…”

“…Il est toutefois très difficile d'entrer en contact avec des souspopulations qui n'éprouvent pas les problèmes poussant leurs aînés à fréquenter les structures de prévention et qui, ne se considérant pas comme toxicomanes, ne se reconnaissent sans doute même pas dans les messages de réduction des risques. Les résul-tats de nombreuses études, obtenus en France [9] comme à l'étranger [5,8,7], confirment que les jeunes UDI ne fréquentent pas ou très peu les PES, pourtant destinés à constituer un service de première ligne facilement accessible. Des pratiques innovantes doivent donc être mises en place, en utilisant le travail des pairs ou peut-être des dispositifs non étiquetés «toxicomanie».…”

Reductions in HIV risk behaviour and stable HIV prevalence in syringe‐exchange clients and other injectors in England

“…Most operate from community-based drug agencies and, in addition to providing free injecting equipment, condoms and advice on HIV, many refer clients to more specialized agencies to help with a variety of drug, HIV and welfare problems. They attempt to be accessible and attractive to clients, operate with minimal rules and reach many people who are not reached by more conventional services [1][2][3][4][5].…”