title: Evaluation of syringe-exchange for HIV prevention among injecting drug users in rural and urban areas of Wales.
abstract: This paper considers the prevention of HIV in rural and urban areas among both opiate and non-opiate drug injectors. A 2-year study evaluated specialist and community based syringe-exchange provision in Wales. Numbers of clients and patterns of attendance at eight syringe-exchange schemes were monitored together with comparative cross-sectional studies of attenders (n = 152) and non-attenders (n = 176) from the population of drug injectors in 1990 and 1991. A total of 1171 clients made 7553 visits in the 2-year period, 110,000 syringes were issued and 80% of needles and syringes were returned. There were few demographic differences between attenders and non-attenders, but large and significant differences in HIV risk behaviour; only 9% of attenders had recently shared syringes in 1990 (10% in 1991) compared to 41% of non-attenders (39% in 1991). The catchment areas of specialised services were limited (5 miles or less) and insufficient in rural areas. Alternative community approaches to syringe distribution and exchange are examined.
authors.affiliation: Department of Psychiatry, Charing Cross and Westminster Medical School, University of London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Keene
authors.forename: G V
authors.initials: GV
authors.lastname: Stimson
authors.forename: S
authors.initials: S
authors.lastname: Jones
authors.forename: N
authors.initials: N
authors.lastname: Parry-Langdon
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000635:transmission*; D006293:Health Promotion; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009294:Narcotics / Q000009:adverse effects* / Q000145:classification; D016485:Needle Sharing; D011329:Prisoners; D012424:Rural Population; D012725:Sexual Behavior / Q000187:drug effects; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population
chemical_list: D009294:Narcotics