title: Approval of syringe exchange programs in California: results from a local approach to HIV prevention.
abstract: OBJECTIVE
  We studied the effect of local approval of syringe exchange programs in California (through Assembly AB136) on program availability and performance.
  
  
  METHODS
  We determined the number of active syringe exchange programs in California by conducting Internet searches and obtaining information from the state and from local programs. To track changes in program availability and performance between 2000 and 2002, we interviewed 24 program directors annually for 3 years about program characteristics, syringe exchange policies, law enforcement contact, and other issues. We conducted multivariate analyses to determine whether AB136 approval status was associated with changes in performance.
  
  
  RESULTS
  Fifteen local governments (13 counties and 2 cities) enacted the new law by 2002, and operating syringe exchange programs increased from 24 to 35. The proportion of these programs that were not locally approved declined from 54% to 40%. No new approved programs were started in high-need counties. Total syringes exchanged increased by more than 1 million per year, average annual budgets increased by more than 50%, and police harassment of the program volunteers, clients, and operators declined. Improvements at approved syringe exchange programs accounted for these changes.
  
  
  CONCLUSIONS
  Statewide approval and funding appears necessary to further syringe exchange availability in California.
authors.affiliation: Health Program and Drug Policy Research Center, Rand Corp, 1776 Main S, PO Box 2138, Santa Monica, CA 90407-2138, USA. rickyb@rand.org
authors.forename: Ricky N
authors.initials: RN
authors.lastname: Bluthenthal
authors.forename: Keith G
authors.initials: KG
authors.lastname: Heinzerling
authors.forename: Rachel
authors.initials: R
authors.lastname: Anderson
authors.forename: Neil M
authors.initials: NM
authors.lastname: Flynn
authors.forename: Alex H
authors.initials: AH
authors.lastname: Kral
mesh_terms: D002140:California; D003625:Data Collection; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D009111:Local Government; D015999:Multivariate Analysis; D018671:Needle-Exchange Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D011050:Policy Making; D011640:Public Policy