Syringe exchange programs (SEPs) and pharmacies provide access to sterile syringes and can increase access to health and social services for injection drug users (IDUs). However, limited hours of service, limited geographic coverage, and concerns about accessing syringes in highly visible places keep many IDUs from attending SEPs and pharmacies. IDUs who do not visit SEP sites may nonetheless be receiving their prevention materials and information through networks of satellite syringe exchangers (SSEs).
Individuals who collect used syringes from their peers, exchange them for new syringes at SEP sites, and deliver them back to their peers, along with additional prevention materials and information.
As long as there has been needle exchange, SSEs have been filling gaps in harm reduction services to IDUs. To date, however, limited evaluation of the effectiveness of SSE activities in reducing viral transmission risks has been conducted.
In California, sharing of contaminated syringes and other injection equipment is linked to 19 percent of all reported AIDS cases and at least 60 percent of hepatitis C cases. Increased access to sterile syringes among injection drug users (IDUs) reduces viral transmission among IDUs, their sex partners and children. A peer-based HIV prevention intervention was initiated by the California Department of Health Services (CDHS) Office of AIDS in 2004. The new intervention is the first to formalize the relationship between SSEs and the public health system. SSEs are recruited from the community, surveyed in order to allow project staff to learn about SSE risk behaviors and prevention efforts with IDUs, and trained to improve their role as peer educators within the IDU community.
SSEs in Humboldt, Mendocino, Alameda, Santa Cruz and Los Angeles are being trained as peer educators to provide health education and harm reduction services to IDUs.
A peer-based HIV prevention intervention was initiated by the California Department of Health Services (CDHS) Office of AIDS in 2004. The new intervention is the first to formalize the relationship between SSEs and the public health system. SSEs are recruited from the community, surveyed in order to allow project staff to learn about SSE risk behaviors and prevention efforts with IDUs, and trained to improve their role as peer educators within the IDU community.
Formalizing the prevention role of SSEs within the public health system has enhanced the harm reduction services of existing SEPs and pharmacies within a broader community of IDUs. Many SSEs are eager to step up their role as HIV prevention experts in the community. Over time, and with consistent support, it appears that SSEs can be trained to more effectively reduce their own HIV risk behaviors and to better reduce risk in their extensive peer groups.
Formalizing the prevention role of SSEs within the public health system has enhanced the harm reduction services of existing SEPs and pharmacies within a broader community of IDUs. Many SSEs are eager to step up their role as HIV prevention experts in the community. Over time, and with consistent support, it appears that SSEs can be trained to more effectively reduce their own HIV risk behaviors and to better reduce risk in their extensive peer groups.
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