title: Lessons learned from a peri-urban needle exchange.
abstract: BACKGROUND
  Injection drug users continue to be at high risk of HIV and HCV. Research has shown that needle exchange programs (NEP) decrease injection frequency, reduce syringe reuse, and reduce needle sharing, though some results have been mixed.
  
  
  METHODS
  This evaluation of a small, peri-urban, legal NEP near Ypsilanti, Michigan describes the operation of the NEP and its clients. It uses interviews conducted with NEP participants between 2003 and 2006, describing the population served by the program, and draws on limited comparisons between matched baseline and follow-up measures as well as aggregate baseline and follow-up comparisons.
  
  
  RESULTS
  The HIV/AIDS Resource Center (HARC) Harm Reduction NEP serves a diverse population from a wide geographical area. NEP participants at follow-up reused their syringes significantly fewer times before getting new ones, were significantly less likely to report giving another IDU a previously used syringe, and were more likely to clean their skin with alcohol either before or after injecting than the baseline comparison group.
  
  
  CONCLUSIONS
  The limited data presented here suggest that a NEP can be an effective method of harm reduction even in low-volume, non-urban settings and are an important venue for intervention in peri-urban areas.
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA. aknittel@umich.edu
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Knittel
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Wren
authors.forename: Lemont
authors.initials: L
authors.lastname: Gore