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Needle Exchange Program (needle + exchange_program)

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Medical Sciences100%

Selected Abstracts

Improving substance abuse treatment enrollment in community syringe exchangers

ADDICTION, Issue 5 2009
Michael Kidorf
ABSTRACT Aims The present study evaluated the effectiveness of an intervention combining motivational enhancement and treatment readiness groups, with and without monetary incentives for attendance and treatment enrollment, on enhancing rates of substance abuse treatment entry among new registrants at the Baltimore Needle Exchange Program (BNEP). Design Opioid-dependent study participants (n = 281) referred by the BNEP were assigned randomly to one of three referral interventions: (i) eight individual motivational enhancement sessions and 16 treatment readiness group sessions (motivated referral condition,MRC); (ii) the MRC intervention with monetary incentives for attending sessions and enrolling in treatment,MRC+I); or (iii) a standard referral condition which directed participants back to the BNEP for referral (standard referral,SRC). Participants were followed for 4 months. Findings MRC+I participants were more likely to enroll in any type of treatment than MRC or SRC participants (52.1% versus 31.9% versus 35.5%; ,2 = 9.12, P = 0.01), and more likely to enroll in treatment including methadone than MRC or SRC participants (40.4% versus 20.2% versus 16.1%; ,2 = 16.65, P < 0.001). MRC+I participants also reported less heroin and injection use than MRC and SRC participants. Conclusions Syringe exchange sites can be effective platforms to motivate opioid users to enroll in substance abuse treatment and ultimately reduce drug use and number of drug injections. [source]

Efficient allocation of resources to prevent HIV infection among injection drug users: the Prevention Point Philadelphia (PPP) needle exchange program

HEALTH ECONOMICS, Issue 2 2006
Zoë K. Harris
Abstract The objective of this study is to determine the allocation of resources within a multi-site needle exchange program (NEP) that achieves the largest possible reduction in new HIV infections at minimum cost. We present a model that relates the number of injection drug user (IDU) clients and the number of syringes exchanged per client to both the costs of the NEP and the expected reduction in HIV infections per unit time. We show that cost-effective allocation within a multi-site NEP requires that sites be located where the density of IDUs is highest, and that the number of syringes exchanged per client be equal across sites. We apply these optimal allocation rules to a specific multi-site needle exchange program, Prevention Point Philadelphia (PPP). This NEP, we find, needs to add 2 or 3 new sites in neighborhoods with the highest density of IDU AIDS cases, and to increase its total IDU client base by about 28%, from approximately 6400 to 8200 IDU clients. The case-study NEP also needs to increase its hours of operation at two existing sites, where the number of needles distributed per client is currently sub-optimal, by 50%. At the optimal allocation, the estimated cost per case of HIV averted would be $2800 (range $2300,$4200). Such a favorable cost-effectiveness ratio derives primarily from PPP's low marginal costs per distributed needle. Copyright © 2005 John Wiley & Sons, Ltd. [source]

Profiles of Self-Reported HIV-Risk Behaviors Among Injection Drug Users in Methadone Maintenance Treatment, Detoxification, and Needle Exchange Programs

PUBLIC HEALTH NURSING, Issue 1 2006
Hayley Diana Mark
ABSTRACT Objective: Injection drug use has accounted for more than one third of acquired immune deficiency syndrome cases in the United States. The purpose of this study was to compare the demographic characteristics, types, and frequency of human immunodeficiency virus (HIV)-risk behaviors among injection drug users (IDUs) recruited from a needle exchange program (NEP), methadone maintenance treatment (MMT), and detoxification (detox) program. Design: A cross-sectional, correlational design was used to determine whether the selected HIV-risk behaviors and demographic characteristics of IDUs varied by site of recruitment. Sample and Measurements: Confidential questionnaires were completed by 445 IDUs in Philadelphia, Pennsylvania. Results: Data analysis revealed that HIV sexual and injection-risk behavior varied by recruitment site. Subjects recruited from the NEP were more likely to engage in HIV-risk behaviors than subjects recruited from the MMT or detox sites. Conclusions: Interventions occurring in program and treatment sites need to be sensitive to various demographic characteristics and behaviors if they are to reach those at highest risk of HIV infection. Targeting HIV prevention interventions based upon risk group membership alone (e.g. IDUs) fails to address the distinct risk behaviors and demographic characteristics of enrollees in different programs. [source]