title: Needle and syringe distribution trends in Western Australia, 1990 to 2009.
abstract: OBJECTIVE
  To describe needle and syringe distribution trends of needle and syringe programs (NSP) between 1990 and 2009 in Western Australia, and explore contributing factors within the national and state strategic and legislative environment.
  
  
  METHODS
  The number of needles and syringes distributed by each of the four NSP types [needle and syringe exchange program (NSEP); health service; pharmacy; vending machine] between 1990 and 2009 were stratified by time period and geographic location using Microsoft Excel.
  
  
  RESULTS
  Total needle and syringe distribution over the 20-year period increased by eight-fold. Regional areas experienced the highest growth: 20-fold increase compared with seven-fold increase in metropolitan areas. The proportion of needles and syringes distributed through NSEPs increased from 33% to 62% between 1990 and 2009, and through health services increased from 3% to 8% between 1994 and 2009. The proportion distributed through pharmacies decreased from 67% to 28% between 1990 and 2009, and through vending machines from 7% to 1.3% between 1992 and 2009. National and state HIV and hepatitis C strategies guided NSP provision at an early stage, and expedited legislative amendments to allow for the operation of approved NSPs.
  
  
  CONCLUSIONS
  The majority of growth occurred through the NSEPs and health service NSPs, which are publicly funded NSPs and provide injecting equipment either on 'exchange' or free-of-charge respectively. The Health Department of Western Australia recognises the increasing reliance on publicly funded NSPs and the need to continue this cost-effective public health program.
authors.affiliation: Sexual Health and Blood-borne Virus Program, Communicable Disease Control Directorate, Department of Health, Perth, Australia.
authors.forename: Georgiana
authors.initials: G
authors.lastname: Lilley
authors.forename: Donna B
authors.initials: DB
authors.lastname: Mak
authors.forename: Trinity
authors.initials: T
authors.lastname: Fredericks
mesh_terms: D006801:Humans; D016485:Needle Sharing / Q000639:trends; D018671:Needle-Exchange Programs / Q000379:methods / Q000639:trends*; D009339:Needles / Q000639:trends*; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology; D013594:Syringes / Q000639:trends*; D014904:Western Australia / Q000453:epidemiology