Needle-Exchange Programs Reduce Needle Sharing, HIV Exposure, Review of Studies Says
Needle sharing, a "major source" of HIV transmission, is reduced in communities with needle-exchange programs, University of California-Davis researchers conclude in a study published in the current issue of the journal AIDS. The New York Times reports that Dr. David Gibson and colleagues reviewed 42 needle-exchange studies published between 1989 and 1999 and found that 28 of these studies revealed "a clear reduction in the risk of HIV infection." While 12 studies showed no benefit and two showed that needle exchanges increased the risk of HIV, the Davis researchers found "flaws" in these studies that may have "masked the benefits" of the programs. For example, all 14 studies were conducted in areas where needles could be purchased legally in drug stores, "potentially diluting the effect" of the needle-exchange programs. Only five of the 28 studies reporting positive findings were conducted in such areas. The 28 positive studies revealed that when needle exchanges were tried in places such as San Francisco, Portland, Ore., Tacoma, Wash., and Baltimore, needle sharing fell by 16% to 72%. While Davis researchers noted that the programs alone may not be enough to prevent the spread of HIV among IV drug users, the decrease in needle-sharing rates indicates a decreased risk of HIV infection. However, a Johns Hopkins study published in the August Journal of Acquired Immune Deficiency Syndromes shows that a majority of Baltimore drug users continue to buy needles on the street rather than exchange them: Only 4% of Baltimore drug users told researchers they used needles from exchange programs exclusively (New York Times, 8/7).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.