title: Secondary syringe exchange among injection drug users.
abstract: Syringe-exchange programs (SEPs) have proven to prevent the spread of bloodborne pathogens, primarily human immunodeficiency virus (HIV), among injection drug users (IDUs). In the United States, only about 7% of IDUs have access to and use SEPs. Some IDUs engage in secondary syringe exchange (SSE), meaning that one IDU (a "provider") obtains syringes at an SEP to distribute to other IDUs ("recipients"). This formative qualitative research was conducted to understand why and how IDUs engage in SSE to aid in the development of a large-scale peer HIV prevention intervention. Interviews with 47 IDUs in Oakland and Richmond, California, indicated that SSE was embedded in existing social networks, which provided natural opportunities for peer education. SSE providers reported a desire to help other IDUs as their primary motivation, while recipients reported convenience as their primary reason for using SSE. Building SSE into SEP structures can facilitate an effective provision of risk reduction supplies and information to IDUs who do not access SEPs directly.
authors.affiliation: Departments of Family and Community Medicine, University of California, San Francisco, CA 94110, USA.
authors.forename: Judith
authors.initials: J
authors.lastname: Snead
authors.forename: Moher
authors.initials: M
authors.lastname: Downing
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lorvick
authors.forename: Barbara
authors.initials: B
authors.lastname: Garcia
authors.forename: Robert
authors.initials: R
authors.lastname: Thawley
authors.forename: Susan
authors.initials: S
authors.lastname: Kegeles
authors.forename: Brian R
authors.initials: BR
authors.lastname: Edlin
mesh_terms: D001294:Attitude to Health / Q000208:ethnology; D002140:California; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000009:adverse effects; D018671:Needle-Exchange Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D010379:Peer Group; D012944:Social Support; D015819:Substance Abuse, Intravenous / Q000208:ethnology / Q000821:virology*