title: State laws, syringe exchange, and HIV among persons who inject drugs in the United States: History and effectiveness.
abstract: In 1981, when acquired immune deficiency syndrome (AIDS) was first observed among persons who inject drugs, almost all US states had laws criminalizing the possession and distribution of needles and syringes for injecting illicit drugs. We reviewed changes to these laws to permit 'syringe exchanges' and the provision of public funding for such programs. Most of the changes in law occurred during the 1990s, 5-10 years later than in many other countries. Public funding of syringe exchanges is associated with lower rates of human immunodeficiency virus (HIV) infection, greater numbers of syringes distributed (a possible causal mechanism), and greater numbers of health and social services provided. Experience in the United states may prove useful in other countries: state, provincial, and local governments may need to move ahead of central governments in addressing HIV infection among persons who inject drugs.
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Bramson
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Nugent
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Vivian
authors.initials: V
authors.lastname: Guardino
authors.affiliation: Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, 160 Water Street - 24th floor, New York, NY 10038, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Feelemyer
authors.affiliation: amfAR, 1150 17th Street NW, Suite 406, Washington DC 20005, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Hodel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D018671:Needle-Exchange Programs / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D013219:State Government; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology