title: An interview study of participants in the Tacoma, Washington, syringe exchange.
abstract: Although European and Australian studies of syringe exchange programs have reported safer injection among participants and no increase in drug use, the generalizability of these findings to the US is uncertain. We report on the operations and potential effectiveness of the longest-operating syringe exchange in the US and compare our results to studies of exchange programs outside the US. The sample of 204 study subjects reported no change in the frequency of injection, from 155 to 152 injections per month, and a decline in the frequency of unsafe injections, from 56 to 30 times per month, while participating in the program. In all studies, participants report reduction in unsafe injections, and no increase in illicit drug use. However, the comparison also suggests that a high proportion of Tacoma exchangers have higher initial rates of drug injection, unsafe injection and homelessness, all of which were associated with unsafe injection while using the exchange. These indicate a need for additional services but that the Tacoma program is no less effective than European and Australian programs.
authors.affiliation: Tacoma-Pierce County Health Department, Washington.
authors.forename: H
authors.initials: H
authors.lastname: Hagan
authors.forename: D C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: D
authors.initials: D
authors.lastname: Purchase
authors.forename: S R
authors.initials: SR
authors.lastname: Friedman
authors.forename: T
authors.initials: T
authors.lastname: Reid
authors.forename: T A
authors.initials: TA
authors.lastname: Bell
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D000328:Adult; D005260:Female; D006293:Health Promotion; D006306:Health Surveys; D006801:Humans; D008297:Male; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires; D013594:Syringes / Q000706:statistics & numerical data*; D014481:United States; D014861:Washington