Needle exchanges are innovative but controversial interventions designed to reduce the spread of the Human Immunodeficiency Virus (HIV) among injection drug users (IDUs). Proponents argue that they are the most direct and powerful measure we have for achieving that goal, while critics say that such programs condone and encourage drug use. Objective evaluation of needle exchange programs is crucial to a resolution of this debate, and to provide guidance to public health policy. We propose a longitudinal cohort study of the impact of Seattle - King County's Needle Exchange, which has been in operation since April of 1989, and which has exchanged over 608,000 syringes. IDUs who have used the needle exchange (exposed cohort) will be compared to IDUs who have not used the needle exchange (unexposed cohort) to observe changes in the practice of high risk sexual and drug injecting behaviors, the acquisition of sexually and parenterally acquired infections, changes in frequency of drug injection, entrance into drug treatment, and changes in knowledge of HIV transmission and its prevention. Steps will be taken in the design and analysis to minimize, assess, and control for the potential bias introduced by self-selection to exchange patronage, and by possible differential follow-up among exchangers and non-exchangers. Logistic regression modeling will enable control for potential confounders.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA008023-02
Application #
2120467
Study Section
Sociobehavioral Subcommittee (DAAR)
Project Start
1993-04-01
Project End
1998-03-31
Budget Start
1994-04-01
Budget End
1995-03-31
Support Year
2
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Seattle-King County Public Health Department
Department
Type
DUNS #
City
Seattle
State
WA
Country
United States
Zip Code
98104
Burt, Richard D; Hagan, Holly; Sabin, Keith et al. (2010) Evaluating respondent-driven sampling in a major metropolitan area: Comparing injection drug users in the 2005 Seattle area national HIV behavioral surveillance system survey with participants in the RAVEN and Kiwi studies. Ann Epidemiol 20:159-67
Brewer, Devon D; Hagan, Holly; Hough, Eileen S (2008) Improved injection network ascertainment with supplementary elicitation techniques. Int J STD AIDS 19:188-91
Burt, Richard D; Hagan, Holly; Garfein, Richard S et al. (2007) Trends in hepatitis B virus, hepatitis C virus, and human immunodeficiency virus prevalence, risk behaviors, and preventive measures among Seattle injection drug users aged 18-30 years, 1994-2004. J Urban Health 84:436-54
Brewer, Devon D; Hagan, Holly; Sullivan, Daniel G et al. (2006) Social structural and behavioral underpinnings of hyperendemic hepatitis C virus transmission in drug injectors. J Infect Dis 194:764-72
Zunt, Joseph R; Tapia, Ken; Thiede, Hanne et al. (2006) HTLV-2 infection in injection drug users in King County, Washington. Scand J Infect Dis 38:654-63
Hagan, Holly; Thiede, Hanne; Des Jarlais, Don C (2004) Hepatitis C virus infection among injection drug users: survival analysis of time to seroconversion. Epidemiology 15:543-9
Perdue, Thomas; Hagan, Holly; Thiede, Hanne et al. (2003) Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men. AIDS Educ Prev 15:81-92
Hagan, Holly; Snyder, Nadine; Hough, Eileen et al. (2002) Case-reporting of acute hepatitis B and C among injection drug users. J Urban Health 79:579-85
Hagan, H; Thiede, H; Weiss, N S et al. (2001) Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health 91:42-6
O'Driscoll, P T; McGough, J; Hagan, H et al. (2001) Predictors of accidental fatal drug overdose among a cohort of injection drug users. Am J Public Health 91:984-7

Showing the most recent 10 out of 14 publications