A Cultural Impact of Needle Exchange: The Role of Safer-Injection Mentors (original) (raw)
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Social work in public health, 2016
Infectious disease remains a significant social and health concern in the United States. Preventing more people from contracting HIV/AIDS or Hepatitis C (HCV), requires a complex understanding of the interconnection between the biomedical and social dimensions of infectious disease. Opiate addiction in the US has skyrocketed in recent years. Preventing more cases of HIV/AIDS and HCV will require dealing with the social determinants of health. Needle exchange programs (NEPs) are based on a harm reduction approach that seeks to minimize the risk of infection and damage to the user and community. This article presents an exploratory small-scale quantitative study of the injection drug using habits of a group of injection drug users (IDUs) at a needle exchange program in Fresno, California. Respondents reported significant decreases in high risk IDU behaviors, including sharing of needles and to a lesser extent re-using of needles. They also reported frequent use of clean paraphernalia....
Needle Exchange and Injection-Related Risk Behaviors in Chicago
JAIDS Journal of Acquired Immune Deficiency Syndromes, 2007
Objective: To examine whether needle exchange program (NEP) use by injecting drug users (IDUs) affects injection risk behaviors over time. Methods: Between 1997 and 2000, 901 IDUs in Chicago were recruited for a cohort study from a multisite NEP and an area with no NEP. Participants were interviewed and tested for HIV at baseline and 3 annual follow-ups. Non-NEP users received HIV prevention services consistent with the Indigenous Leader Outreach Model. Random-effect logistic models were used to compare 5 injectionrelated risk behaviors between NEP users and nonusers. Results: The 30-day prevalence of receptive needle sharing decreased from 27.6% at baseline to 10.0% at visit 4 in NEP users and from 47.1% to 20.0% in nonusers. Similar patterns were observed for lending used needles, and NEP users were less likely to reuse their own needles. In multivariate analyses, NEP use was significantly associated with reduced odds of greater than 60% for receptive needle sharing, 45% for lending used needles, and 30% for sharing other injection paraphernalia as well as approximately a 2-fold increase in the odds of always bleaching used needles. Conclusions: NEP use facilitates long-term reductions in injection risk practices, and the reductions are in addition to the effects of a behavioral intervention alone.
Sexually transmitted diseases, 2009
To examine the impact of a needle exchange program (NEP) on sexual risk behaviors of injecting drug users (IDUs). : Between 1997 and 2000, 889 IDUs in Chicago were recruited from NEPs and an area with no NEP into a cohort study. They were interviewed and tested for HIV at baseline and 3 annual follow-up visits. Random-effect logistic models were used to compare NEP users and nonusers regarding the number of sex partners, number of unprotected sex acts, and frequency of condom use. Compared to NEP nonusers, NEP users had a similar number of sex partners over time, but had 49% higher odds of using condoms with their main partners (P = 0.047). At baseline, there was no difference between NEP users and nonusers in episodes of vaginal intercourse, but over time the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26% per year for NEP users but only 10% per year for nonusers (P = 0.02). This study suggests that NEP participation may help reduc...
AIDS and Behavior, 2000
This study was conducted to determine whether enrollment in a needle exchange program (NEP) was associated with reduction(s) in high-risk injection practices among HIV-seropositive drug users. Between August 1994 and August 1997 HIV-seropositive individuals who underwent baseline and 6-month follow-up visits in the Baltimore NEP evaluation were studied. Chi-square statistics and paired t tests were used to compare reported injectionrelated behaviors between visits. One hundred and twelve HIV-seropositive NEP participants completed baseline and follow-up visits. Between visits self-reported lending of used syringes to others decreased (34.0% vs. 15.5%, p ϭ .001), borrowing syringes from others decreased (23.2% vs. 11.1%, p ϭ .002), and reported participation in drug treatment increased (8.0% vs. 18.8%, p ϭ .01). A decrease in the mean number of injections per syringe was reported, 11.4 vs. 4.7 (p Ͻ .001). These data suggest that NEP attendance can contribute to significant reductions in risky drug-use behaviors in HIV-seropositive drug users.
The role of needle exchange programs in HIV prevention
Public health reports (Washington, D.C. : 1974), 1998
Injecting drug users (IDUs) are at high risk for infection by human immunodeficiency virus (HIV) and other blood-borne pathogens. In the United States, IDUs account for nearly one-third of the cases of acquired immunodeficiency syndrome (AIDS), either directly or indirectly (heterosexual and perinatal cases of AIDS where the source of infection was an IDU). IDU also account for a substantial proportion of cases of hepatitis B (HBV) and hepatitis C (HCV) virus infections. The primary mode of transmission of HIV among IDUs is parenteral, through direct needle sharing or multiperson use of syringes. Despite high levels of knowledge about risk, multiperson use of needles and syringes is due primarily to fear of arrest and incarceration for violation of drug paraphernalia laws and ordinances that prohibit manufacture, sale, distribution, or possession of equipment and materials intended to be used with narcotics. It is estimated that in 1997 there were approximately 110 needle exchange p...
Correlates of needle sharing among injection drug users
American Journal of Public Health, 1994
The sharing of contaminated injection equipment is the primary mode of human immunodeficiency virus (HIV) transmission for injection drug users. This study examined demographic factors, life events, and drug use practices that are potential risk factors for sharing injection equipment. Between February 1988 and March 1989, 2921 active injection drug users were interviewed and questioned about their backgrounds, life-styles, and patterns of injection drug use. Of 2524 participants who reported injecting drugs within the 6 months prior to study enrollment, 70.4% reported recent needle sharing. A multivariate analysis found needle sharing to be more frequent among those with a history of arrest and lower socioeconomic status, even after accounting for other demographic and drug use variables. In addition, recent needle sharing was higher in male homosexual or bisexual men than in their heterosexual counterparts. These data suggest that injection drug users have an economic motive to share needles and that the availability of free and legal needles may reduce levels of needle sharing.
Determinants of HIV Risk and Protective Needle-Sharing Behaviors Among Drug Injectors
Journal of Applied Biobehavioral Research, 2011
Few studies have tested a broad range of theory-based determinants of injection-related risk and protective behaviors. The current study hypothesize relationships among attitudinal beliefs, normative influences, perceived self-efficacy, intentions, and performing these behaviors consistent with the theory of planned behavior and related models. The conceptual model was tested in a cross-sectional sample of 895 drug injectors recruited from street settings in the southwestern United States and who completed a face-to-face interview. Structural equation modeling results showed intention and self-efficacy most consistently predicted needle sharing and bleaching considering all other model variables. Discussion focuses on the value of using these theoretical concepts to examine needle sharing and other behaviors among injection drug users and their relevance for developing HIV-reduction interventions.j abr_ 98..120