title: New needle and syringe use, and use of needle exchange programmes by street recruited injection drug users in 1993.
abstract: BACKGROUND
  Needle exchange programmes (NEP) provide injection drug users (IDU) with sterile injection equipment and receive used needles in exchange. In this paper we describe the use of new syringes and NEP by IDU and characteristics associated with using NEP in 1993.
  
  
  METHODS
  Street-recruited IDU were interviewed in five US locations: Atlanta, Philadelphia, Chicago, New York City, and Los Angeles (LA) county.
  
  
  RESULTS
  Most (75-95%) reported it was easy to get a new syringe and for their last injection, 45-77% used a new syringe and 2-18% used a syringe previously used by another IDU. Use of NEP ranged from 8% to 16% in Chicago, Philadelphia, and LA County. In LA County not having injected 'speedball' in the last 30 days, last injection with a new syringe, and reporting it was very easy to get a new syringe were associated with NEP use. In Philadelphia, NEP use was associated with 'speedball' injection in the last 30 days, and in Chicago, not injecting with 'speedball' and injecting with cocaine were associated with NEP use.
  
  
  CONCLUSIONS
  In 1993, most street-recruited IDU in Chicago, Philadelphia, and LA County had not used NEP. Factors associated with NEP use were not consistent across sites. Dispersion of NEP and removal of legal barriers restricting access to sterile syringes may be more important in increasing the use of sterile syringes and NEP than client characteristics.
authors.affiliation: Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Atlanta, GA 30333, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: MacGowan
authors.forename: C E
authors.initials: CE
authors.lastname: Sterk
authors.forename: A
authors.initials: A
authors.lastname: Long
authors.forename: R
authors.initials: R
authors.lastname: Cheney
authors.forename: M
authors.initials: M
authors.lastname: Seeman
authors.forename: J E
authors.initials: JE
authors.lastname: Anderson
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009294:Narcotics; D016485:Needle Sharing / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D009339:Needles / Q000706:statistics & numerical data*; D018579:Patient Selection; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013594:Syringes / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
chemical_list: D009294:Narcotics