Global Study Supports Needle Exchange in HIV Prevention

A new study reported in the International Journal of Drug Policy (issue 14.5/6, published in December 2003) reinforces the beneficial impact of needle and syringe exchange programs for preventing HIV/AIDS among injecting drug users.

The study focused on injecting drug use and HIV infection in 99 cities and showed that distributing sterile needles and syringes helps prevent the spread of HIV infection. HIV prevalence decreased (by 19 percent a year) in cities that introduced needle exchanges, but increased (by 8 percent a year) in cities that had never had needle exchanges.

The lead author of the report, Margaret MacDonald, said, "The study provides additional evidence that needle and syringe programs reduce transmission of HIV infection. The rapid spread of HIV among injecting drug use populations, and increasing rates of injecting in many countries calls for a vigorous scaling up of needle and syringe programmes as well as other harm reduction strategies."

Gerry Stimson, editor in chief of the International Journal of Drug Policy, announcing this study on Global AIDS Day, December 1, 2003, said: "This study shows that levels of HIV infection decreased in cities with needle and exchange programs, but increased in cities without needle and syringe programs. This confirms other studies that show that harm reduction interventions are effective for preventing HIV infection in injecting drug users."

This study is one of 17 scientific reports published in a special issue of the International Journal of Drug Policy, reviewing progress with syringe exchange programmes in Brazil, China,  the United States (Anchorage, Baltimore, Harlem, the Bronx, Rhode Island, and Sacramento), Vietnam, the United Kingdom (Merseyside and Cheshire), India (Manipur), Australia, Russia (Moscow), and inside prisons in the European Union.

Tim Rhodes, editor of the International Journal of Drug Policy, said, "These studies join a wealth of international evidence in support of syringe exchange as a method of HIV prevention.   It also shows that they can operate in a wide range of different settings and countries, including in prisons."

Background information

Measures to prevent HIV infection among people who inject drugs generally focus on preventing blood contact during injection by reducing injection or promoting use of sterile equipment when injecting. Needle and syringe programs also provide education about HIV/AIDS, condoms, and referral to drug treatment. Consequently needle and syringe programs are a key strategy for preventing transmission of HIV infection in many countries.

Margaret MacDonald (deceased), author of the report, was a senior researcher at the National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Australia. Further information about her study may be obtained from co-author John Kaldor, also at the National Centre in HIV Epidemiology and Clinical Research.