Needle exchange programs
CMAJ 1997;157:1201
Re: "Needle exchange programs: an economic evaluation of a local experience," CMAJ 1997;157[3]:255-62 [full text / résumé]
In response to: J.H. Battershill
Dr. Battershill is correct about the potential role of a contaminated syringe in transmitting HIV. However, the exchange that takes place in a needle exchange program involves a prepackaged unit containing both a sterile needle and syringe, which is given to injection drug users in exchange for used equipment.
Needle exchange is only one component in a range of services that are provided by most "needle exchange programs" to meet the broader health needs of injection drug users. The Van Needle Exchange Program in Hamilton, Ont., for which we conducted our economic evaluation, provides other harm-reduction services such as assessment and referral to addiction treatment services, anonymous HIV testing, hepatitis B vaccines and safer sex counselling.
The recommendations of the May 1997 National Task Force on HIV and Injection Drug Use advocate further development of policy, legislation and programs to reduce stigmatization and marginalization of injection drug users. Community collaboration and mobilization are integral to this process, but it takes time to build trusting relationships with clients and develop strong community partnerships.
There is much work to be done and the issues are complex. Only by working together will communities be able to build a supportive system that not only reduces barriers to service for injection drug users but also decreases the risk of HIV transmission in the community as a whole.
Michele Gold, MSW
Amiram Gafni, PhD
Penny Nelligan, RN, BScN
Peggy Millson, MD, MHSc
Centre for Health Economics and Policy
Analysis and Department of Clinical
Epidemiology and Biostatistics
McMaster University
Hamilton, Ont.
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