title: Syringe exchange programs in Brazil: preliminary assessment of 45 programs.
abstract: The present study aims to evaluate the current operation of Brazilian syringe exchange programs (SEP). After consulting national and regional networks of people working in projects/programs aiming to reduce drug-related harm, we identified 134 potential participant programs. Unfortunately, only 45 SEPs answered a survey, even after repeated attempts. The survey addressed: coverage, funding, procurement of basic supplies, managerial capacity, and the local political environment. Findings were triangulated with in-depth interviews with key informants. The main findings included: satisfactory adherence to the initiatives and adequate documentation, but deficiencies in terms of coverage and monitoring, and uneven procurement of resources. Program personnel work mostly on a provisional basis, despite the efforts of local coordinators. Most programs are funded by the National STDs/AIDS Program. A comprehensive agenda aiming to improve current operations should include: concerted efforts to improve local and regional databanks, incentives/sanctions toward full accountability of initiatives carried by the programs, and a genuine culture of monitoring and evaluation.
authors.affiliation: Centro de Informação Científica e Tecnológica, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. emassard@cict.fiocruz.br
authors.forename: Elize Massard da
authors.initials: EM
authors.lastname: Fonseca
authors.forename: José Mendes
authors.initials: JM
authors.lastname: Ribeiro
authors.forename: Neilane
authors.initials: N
authors.lastname: Bertoni
authors.forename: Francisco I
authors.initials: FI
authors.lastname: Bastos
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000517:prevention & control*; D040261:Harm Reduction; D006801:Humans; D007407:Interviews as Topic; D018671:Needle-Exchange Programs / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D015397:Program Evaluation; D011640:Public Policy; D015819:Substance Abuse, Intravenous