title: Organizational issues in the implementation of a hospital-based syringe exchange program.
abstract: Little published information exists to guide health care institutions in establishing syringe exchange program (SEP) services. To address this gap, this article discusses organizational issues encountered in the implementation of a hospital-based SEP in San Francisco, California (USA). Investigators collaborated with a community organization in implementing a county hospital-based SEP. SEP services integrated into a public hospital presented unique challenges directly related to their status as a health care institution. In the course of introducing SEP services into a hospital setting as part of a clinical trial, various ethical, legal, and logistical issues were raised. Based on these experiences, this paper provides guidance on how to integrate an SEP into a traditional health care institution.
authors.affiliation: Department of Psychiatry, San Francisco General Hospital Center, University of California, San Francisco, California 94110, USA. Carmen.masson@ucsf.edu
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Masson
authors.forename: James L
authors.initials: JL
authors.lastname: Sorensen
authors.forename: Nina
authors.initials: N
authors.lastname: Grossman
authors.forename: Karl A
authors.initials: KA
authors.lastname: Sporer
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: David C
authors.initials: DC
authors.lastname: Perlman
mesh_terms: D019058:Community Networks / Q000266:history; D015658:HIV Infections; D049673:History, 20th Century; D049674:History, 21st Century; D006779:Hospitals, Public; D006801:Humans; D018671:Needle-Exchange Programs / Q000941:ethics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D016730:Program Development / Q000379:methods; D012495:San Francisco; D015819:Substance Abuse, Intravenous
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