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 #
5R01DA008023-03
Application #
2120468
Study Section
Sociobehavioral Subcommittee (DAAR)
Project Start
1993-04-01
Project End
1998-02-28
Budget Start
1995-04-01
Budget End
1996-02-28
Support Year
3
Fiscal Year
1995
Total Cost
Indirect Cost
Name
Seattle-King County Public Health Department
Department
Type
DUNS #
City
Seattle
State
WA
Country
United States
Zip Code
98104
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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
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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

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