title: Obstacles to needle exchange participation in Rhode Island.
abstract: OBJECTIVE
  This study explores obstacles to participation in needle exchange programs (NEPs) among injection drug users (IDUs) in the state of Rhode Island, U.S.A.
  
  
  METHODS
  A written questionnaire was administered at two Rhode Island drug detoxification sites in 1998.
  
  
  RESULTS
  488 self-administered surveys were completed, 226 (46.3%) respondents had injected drugs in the past 6 months. 62.1% reported sharing syringes in the past 6 months, and each syringe was used a mean of 10.7 times. Major obstacles to NEP participation were a lack of awareness of the program (25.6%), inconvenient location or hours (15.9%), and fear of identification and/or police harassment (12.2%). Non-white race was a significant predictor of being unaware of the NEP (p = .01) and not participating in the NEP (p = .03). 13.1% of IDUs who used the NEP were referred to the detoxification program by the NEP. Among all IDUs surveyed, 51.0% had participated in a NEP.
  
  
  CONCLUSIONS
  NEPs are important in reducing the spread of bloodborne pathogens among IDUs and are effective referral sources for drug treatment. Surveys of IDUs at sites other than NEPs, such as detoxification facilities, can identify obstacles to the use of NEPs.
authors.affiliation: The Miriam Hospital/Brown University, Providence, Rhode Island 02906, USA. Jrich@lifespan.org
authors.forename: J D
authors.initials: JD
authors.lastname: Rich
authors.forename: L
authors.initials: L
authors.lastname: Strong
authors.forename: C W
authors.initials: CW
authors.lastname: Towe
authors.forename: M
authors.initials: M
authors.lastname: McKenzie
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control* / Q000635:transmission; D000328:Adult; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006556:Heroin Dependence; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D012237:Rhode Island; D015819:Substance Abuse, Intravenous; D011795:Surveys and Questionnaires