title: Drug use and HIV risk practices of secondary and primary needle exchange users.
abstract: This study examines HIV risk practices associated with secondary needle exchange, obtaining needles from a needle exchange program (NEP) through others who attend in person. We analyzed data from NEP logs, a survey and HIV testing from 901 drug injectors who (a) always visited NEPs themselves to get needles (primary-only NEP users), (b) obtained at least some NEP needles by having others exchange for them (mixed/secondary NEP users), and (c) obtained no needles from an NEP. About 22% of 40,000 NEP visits involved secondary exchanges, and these accounted for over half of all needles exchanged. In multiple logistic regression analyses, primary-only needle exchange was significantly associated with lower levels of receptive needle sharing, backloading, sharing other injection equipment and lending used needles, and positively associated with obtaining drug treatment. Mixed/secondary needle exchange was associated with less receptive needle sharing and a greater likelihood of drug treatment. Secondary exchange facilitated HIV risk reduction but the salutary effects of NEPs were attenuated in mixed/secondary exchangers.
authors.affiliation: Division of Epidemiology and Biostatistics, Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, IL 60637, USA. dhuo@health.bsd.uchicago.edu
authors.forename: Dezheng
authors.initials: D
authors.lastname: Huo
authors.forename: Susan L
authors.initials: SL
authors.lastname: Bailey
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.forename: Lawrence
authors.initials: L
authors.lastname: Ouellet
mesh_terms: D000328:Adult; D017677:Age Distribution; D002641:Chicago / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data*; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000628:therapy