Frequently Asked Questions

At a syringe access program, injection drug users bring their used equipment to a known exchange site and trade their dirty syringes for clean equipment. Used syringes are disposed of in accordance with established biohazardous waste standards. Syringe access programs are intended to prevent the spread of the HIV virus and other blood-borne diseases, such as hepatitis B and C, among injection drug users and their sexual partners. Equally important as the actual exchange of syringes is the opportunity for outreach workers to provide participants with updated information and referrals regarding medical and social services in the community related to both drug treatment and HIV medical care and support services.

Does needle exchange reduce the number of HIV infections?

Mounting epidemiologic data point to an overall decline in new HIV infections among injection drug users (IDUs) over the past 20 years in the United States, with parallel but more modest decline in hepatitis C rates. Newly revised HIV incidence estimates from the CDC projected that in 2006, injection drug use accounted for 6,600 HIV infections in the U.S., with an additional 2,100 new infections among men who have sex with men (MSM) who also report injecting drugs. The authors note: “Overall, HIV incidence among individuals exposed through IDU has decreased approximately 80% in the United States. Over that time, (people) exposed through IDU have reduced needle sharing by using sterile syringe available through needle exchange programs or pharmacies and have reduced the number of individuals with whom they share needles.”  Similar declines in hepatitis C prevalence among IDUs, though lesser in magnitude, have been reported in several cities with syringe access programs.

Does syringe access increase drug use?

No.  Many scientific studies, including a Surgeon General’s report, show that needle exchange does not increase drug use when conducted with referrals to both drug treatment and HIV and Hepatitis C testing, medical care and support services.

Does syringe access increase the number of contaminated syringes on the street?

No. Syringe access and disposal programs actually encourage individuals to bring back used syringes to trade them in at the syringe access site.  We provide a bio-hazard sharps container which makes it a lot easier and safer for people to carry back used syringes, and also makes it legal to carry syringes when inside an FDA approved container. San Francisco’s syringe access program has reduced the risk to community members from infectious syringes left by injection drug users, according to a new study by researchers at RTI International, San Francisco State University and San Francisco Department of Public Health.

The study, published online May 13 in the American Journal of Public Health, was based on a survey of more than 600 injection drug users in San Francisco and a visual inspection of 1,000 city blocks in areas heavily trafficked by drug users.

How can syringe access help a community?

Syringe access services are about public safety.  Not only do they prevent the transmission of HIV and other blood borne pathogens to people who use injection drugs, but they also protect the community at large by preventing infections among their sexual partners and children.  Most UCHAPS (Urban Coalition for HIV/ AIDS Prevention Services) jurisdictions have successfully developed syringe access services utilizing local and state funds while protecting public safety.  Each local health jurisdiction has developed the services with an understanding of their urban landscapes and their communities’ needs in order to save money by preventing costly-to-treat infections and, more importantly, to save lives.

Do Americans support syringe access?

Yes.  Surveys done in the late 1990’s as well as a Kaiser Family Foundation Survey from 1996 found that 66% of Americans support such programs.  As time has progressed, and communities learn the life saving and cost saving benefits of these programs, a growing number of people seem to understand the importance of syringe access.  Over 100 syringe access programs exist in the United States, in both fixed and mobile sites.   Many offer access to drug treatment, safer sex materials, medical care and other health related benefits.  Local communities have developed and implemented syringe access programs, which operate in a manner appropriate to community standards.

What is our current federal policy on syringe access?

Health and Human Services programs are interested in implementing syringe services programs, or SSP, for injection drug users. The term SSP includes syringe access, disposal, and needle exchange programs, as well as referral and linkage to HIV prevention services, substance abuse treatment, and medical and mental health care  

In December 2009, the president signed the Consolidated Appropriations Act, 2010, which modified the ban on use of federal funds for needle exchange programs for many Health and Humans Services programs. However, authorizations for some programs may still contain partial or complete bans on the use of funds for needle exchange, and grantees should contact their relevant program office for additional information. The modified provision prohibits the use of funds for syringe exchange programs in any location that local public health or law enforcement agencies determine to be inappropriate.

The federal government is committed to working with grantees and partners to obtain input on long-term, comprehensive SSP guidance for implementing this public health strategy to reduce the spread of HIV and other infections. Health and Human Services is also committed to working with grantees to develop and implement appropriate monitoring and evaluation plans for syringe services programs.

What should the federal government do regarding syringe access? 

In 2009, a group of syringe access professionals, advocates and clients met to compile a “best practices” document regarding syringe access.  In the fall of 2010, many people on this committee met with the CDC in Atlanta to propose their ideas and encourage the CDC to make sure that the federal government would enlist as many of the “best practices” as possible.

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