Proposed is a competing renewal application to continue evaluation of the effectiveness of the Baltimore Needle Exchange Program (NEP). The evaluation is in terms of behavioral risk reduction, HIV seroincidence, and comparisons of characteristics and utilization patterns between those who use a van-based versus pharmacy-based NEP. The Baltimore City Health Department has operated NEP vans in East and West Baltimore since 1994 and will open two pharmacy-based NEPs in West Baltimore in 1997. All NEP sites will offer unlimited one-for-one exchange. Data on drug use behaviors and HIV testing are obtained semi-annually on 2,000 injection drug users, throughout the city, who are participants in ongoing longitudinal studies. Analyses use person-time techniques to compare relative incidence by NEP participation, and also by access versus no access to NEP (i.e. Baltimore city versus county). To address the second generation question of which types of programs attract what types of clients (and which is most effective), we will collect demographic, drug use and NEP utilization information on all participants at all sites. We will compare characteristics of pharmacies versus van in West Baltimore; vans in East and West Baltimore before and after opening pharmacy NEP; and stable van users versus those who switch over to pharmacies. This study will provide new information on the impact of NEP in a community of IDUs, as well as define how different types of programs attract different clientele. This information will provide all NEP services with information enabling them to tailor services and optimize HIV risk reduction.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Hartsock, Peter
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Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
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Brouwer, Kimberly C; Lozada, Remedios; Weeks, John R et al. (2012) Intraurban mobility and its potential impact on the spread of blood-borne infections among drug injectors in Tijuana, Mexico. Subst Use Misuse 47:244-53
Syvertsen, Jennifer; Pollini, Robin A; Lozada, Remedios et al. (2010) Managing la malilla: Exploring drug treatment experiences among injection drug users in Tijuana, Mexico, and their implications for drug law reform. Int J Drug Policy 21:459-65
Philbin, Morgan M; Mantsios, Andrea; Lozada, Remedios et al. (2009) Exploring stakeholder perceptions of acceptability and feasibility of needle exchange programmes, syringe vending machines and safer injection facilities in Tijuana, Mexico. Int J Drug Policy 20:329-35
Ramos, Rebeca; Ferreira-Pinto, João B; Brouwer, Kimberly C et al. (2009) A tale of two cities: Social and environmental influences shaping risk factors and protective behaviors in two Mexico-US border cities. Health Place 15:999-1005
Brouwer, K C; Lozada, R; Cornelius, W A et al. (2009) Deportation along the U.S.-Mexico border: its relation to drug use patterns and accessing care. J Immigr Minor Health 11:1-6
Poon, Art F Y; Brouwer, Kimberly C; Strathdee, Steffanie A et al. (2009) Parsing social network survey data from hidden populations using stochastic context-free grammars. PLoS One 4:e6777
Havens, Jennifer R; Latkin, Carl A; Pu, Minya et al. (2009) Predictors of opiate agonist treatment retention among injection drug users referred from a needle exchange program. J Subst Abuse Treat 36:306-12
Case, Patricia; Patricia, Case; Ramos, Rebeca et al. (2008) At the borders, on the edge: use of injected methamphetamine in Tijuana and Ciudad Juarez, Mexico. J Immigr Minor Health 10:23-33
Miller, Cari L; Firestone, Michelle; Ramos, Rebeca et al. (2008) Injecting drug users'experiences of policing practices in two Mexican-U.S. border cities: public health perspectives. Int J Drug Policy 19:324-31
Bishai, D; Sindelar, J; Ricketts, E P et al. (2008) Willingness to pay for drug rehabilitation: implications for cost recovery. J Health Econ 27:959-72

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