Syringe Exchange Program Evaluation

A small, mobile Syringe Exchange Program (SEP) was implemented near the beginning of the HIV epidemic to prevent infection among urban injecting drug users. Over the next decade a huge influx of inexpensive heroin occurred and use at the national level increased tremendously.

Since the HIV epidemic in the population had been held in check through rigorous and consistently applied public health measures such as the SEP, both government officials and the public were polarized in terms of expanding the successful syringe exchange program. At issue were concerns of current heroin users switching from smoking to injecting heroin because of the easy availability of needles and syringes.

Data from a variety of sources were identified: three independent surveys were conducted with SEP users over a six year period, SEP staff recorded the sex of all visitors and the number of syringes requested at each visit, and interviews were conducted with SEP staff, the director of the SEP program and other clinicians and public health professionals. Data were analyzed for trends over time.

A minority of SEP users was found to be new injectors and there was no change in the percent of new injectors using the SEP over the six year period. In agreement with numerous other evaluations, there was no evidence to suggest that the SEP had contributed to an increase in new injectors. There was evidence to suggest that the SEP played a major role in controlling the HIV epidemic through the provision of multifaceted services in addition to sterile syringe distribution, including free HIV testing, health education materials and linkages to other services. Based in part on these findings, there was a national expansion of the SEP.