Needle-exchange participation, effectiveness, and policy

Syringe relay, gender, and the paradox of public health

T. Valente, R. Foreman, B. Junge, D. Vlahov

Research output: Contribution to journalArticle

Abstract

Needle-exchange programs (NEPs) have been politically controversial, and most studies have focused on evaluating their effectiveness on human immunodeficiency virus (HIV) transmission rates with little emphasis on the process of how they are used. This article shows that the way intravenous drug users use NEPs may influence their effectiveness. Using data from Baltimore's NEP, participants (N = 2,574) were classified as low, medium, and high users based on the volume, frequency, and duration of contact with the NEP. Higher NEP use was associated with shorter syringe circulation times and less syringe relay, returning syringes to the NEP originally acquired by someone else. For a subsample that was HIV tested (N = 262), syringe relay among women was associated with HIV seroconversion (at a 95% confidence interval). We conclude that exclusive use of the NEP (no relay) provides greater HIV protection than NEP use involving syringe relay. The paradox is that public health goals will not be achieved by prohibiting syringe relay activities and promoting exclusive use. NEPs should broaden their education efforts to have participants understand the value of repeated visits to the NEP.

Original languageEnglish (US)
Pages (from-to)340-349
Number of pages10
JournalJournal of Urban Health
Volume78
Issue number2
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Needle-Exchange Programs
Syringes
Needles
Public Health
public health
participation
gender
HIV
Baltimore
Drug Users
confidence

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Needle-exchange participation, effectiveness, and policy : Syringe relay, gender, and the paradox of public health. / Valente, T.; Foreman, R.; Junge, B.; Vlahov, D.

In: Journal of Urban Health, Vol. 78, No. 2, 2001, p. 340-349.

Research output: Contribution to journalArticle

Valente, T. ; Foreman, R. ; Junge, B. ; Vlahov, D. / Needle-exchange participation, effectiveness, and policy : Syringe relay, gender, and the paradox of public health. In: Journal of Urban Health. 2001 ; Vol. 78, No. 2. pp. 340-349.
@article{1bcd0316437e45fdb4d91a7d03cd4d8f,
title = "Needle-exchange participation, effectiveness, and policy: Syringe relay, gender, and the paradox of public health",
abstract = "Needle-exchange programs (NEPs) have been politically controversial, and most studies have focused on evaluating their effectiveness on human immunodeficiency virus (HIV) transmission rates with little emphasis on the process of how they are used. This article shows that the way intravenous drug users use NEPs may influence their effectiveness. Using data from Baltimore's NEP, participants (N = 2,574) were classified as low, medium, and high users based on the volume, frequency, and duration of contact with the NEP. Higher NEP use was associated with shorter syringe circulation times and less syringe relay, returning syringes to the NEP originally acquired by someone else. For a subsample that was HIV tested (N = 262), syringe relay among women was associated with HIV seroconversion (at a 95{\%} confidence interval). We conclude that exclusive use of the NEP (no relay) provides greater HIV protection than NEP use involving syringe relay. The paradox is that public health goals will not be achieved by prohibiting syringe relay activities and promoting exclusive use. NEPs should broaden their education efforts to have participants understand the value of repeated visits to the NEP.",
author = "T. Valente and R. Foreman and B. Junge and D. Vlahov",
year = "2001",
doi = "10.1093/jurban/78.2.340",
language = "English (US)",
volume = "78",
pages = "340--349",
journal = "Journal of Urban Health",
issn = "1099-3460",
publisher = "Springer Science and Business Media Deutschland GmbH",
number = "2",

}

TY - JOUR

T1 - Needle-exchange participation, effectiveness, and policy

T2 - Syringe relay, gender, and the paradox of public health

AU - Valente, T.

AU - Foreman, R.

AU - Junge, B.

AU - Vlahov, D.

PY - 2001

Y1 - 2001

N2 - Needle-exchange programs (NEPs) have been politically controversial, and most studies have focused on evaluating their effectiveness on human immunodeficiency virus (HIV) transmission rates with little emphasis on the process of how they are used. This article shows that the way intravenous drug users use NEPs may influence their effectiveness. Using data from Baltimore's NEP, participants (N = 2,574) were classified as low, medium, and high users based on the volume, frequency, and duration of contact with the NEP. Higher NEP use was associated with shorter syringe circulation times and less syringe relay, returning syringes to the NEP originally acquired by someone else. For a subsample that was HIV tested (N = 262), syringe relay among women was associated with HIV seroconversion (at a 95% confidence interval). We conclude that exclusive use of the NEP (no relay) provides greater HIV protection than NEP use involving syringe relay. The paradox is that public health goals will not be achieved by prohibiting syringe relay activities and promoting exclusive use. NEPs should broaden their education efforts to have participants understand the value of repeated visits to the NEP.

AB - Needle-exchange programs (NEPs) have been politically controversial, and most studies have focused on evaluating their effectiveness on human immunodeficiency virus (HIV) transmission rates with little emphasis on the process of how they are used. This article shows that the way intravenous drug users use NEPs may influence their effectiveness. Using data from Baltimore's NEP, participants (N = 2,574) were classified as low, medium, and high users based on the volume, frequency, and duration of contact with the NEP. Higher NEP use was associated with shorter syringe circulation times and less syringe relay, returning syringes to the NEP originally acquired by someone else. For a subsample that was HIV tested (N = 262), syringe relay among women was associated with HIV seroconversion (at a 95% confidence interval). We conclude that exclusive use of the NEP (no relay) provides greater HIV protection than NEP use involving syringe relay. The paradox is that public health goals will not be achieved by prohibiting syringe relay activities and promoting exclusive use. NEPs should broaden their education efforts to have participants understand the value of repeated visits to the NEP.

UR - http://www.scopus.com/inward/record.url?scp=0034970014&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034970014&partnerID=8YFLogxK

U2 - 10.1093/jurban/78.2.340

DO - 10.1093/jurban/78.2.340

M3 - Article

VL - 78

SP - 340

EP - 349

JO - Journal of Urban Health

JF - Journal of Urban Health

SN - 1099-3460

IS - 2

ER -