title: Social and political factors predicting the presence of syringe exchange programs in 96 US metropolitan areas.
abstract: Community activism can be important in shaping public health policies. For example, political pressure and direct action from grassroots activists have been central to the formation of syringe exchange programs (SEPs) in the United States. We explored why SEPs are present in some localities but not others, hypothesizing that programs are unevenly distributed across geographic areas as a result of political, socioeconomic, and organizational characteristics of localities, including needs, resources, and local opposition. We examined the effects of these factors on whether SEPs were present in different US metropolitan statistical areas in 2000. Predictors of the presence of an SEP included percentage of the population with a college education, the existence of local AIDS Coalition to Unleash Power (ACT UP) chapters, and the percentage of men who have sex with men in the population. Need was not a predictor.
authors.affiliation: Center for Drug Use and HIV Research, National Development and Research Institutes, Inc, New York, NY 10010, USA. tempalski@ndri.org
authors.forename: Barbara
authors.initials: B
authors.lastname: Tempalski
authors.forename: Peter L
authors.initials: PL
authors.lastname: Flom
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Judith J
authors.initials: JJ
authors.lastname: Friedman
authors.forename: Courtney
authors.initials: C
authors.lastname: McKnight
authors.forename: Risa
authors.initials: R
authors.lastname: Friedman
mesh_terms: D001294:Attitude to Health; D002947:Cities; D003256:Community Participation; D004335:Drug and Narcotic Control; D005843:Geography; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006295:Health Resources / Q000600:supply & distribution; D006301:Health Services Needs and Demand; D006801:Humans; D018671:Needle-Exchange Programs / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000600:supply & distribution*; D011057:Politics; D011593:Psychology, Social; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders; D014481:United States; D019037:Urban Health Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data / Q000600:supply & distribution*