Needle exchange programs (NEPs) are said by advocates to have the following components and consequences: COMPONENT 1: NEPs provide free new needles to IDUs in exchange for used needles. INTENDED CONSEQUENCE: Circulation of contaminated needles is reduced, thereby reducing opportunities for transmission of HIV. COMPONENT 2: NEPs create opportunities for HIV prevention education and risk reduction as staff counsel exchangers in the course of the exchange event. INTENDED CONSEQUENCE: NEP users will further reduce HIV risk-related behavior, causing a decline in new cases of HIV. COMPONENT 3: NEPs provide referral to drug treatment and other social and medical services. INTENDED CONSEQUENCE: NEP users will be more likely to enter drug treatment and receive other services than without NEP referral, causing a decline in HIV-related risk behavior and infection. The NEP research we propose is designed to address these claims and to answer four questions: 1. How does an NEP operationalize its intervention components, and how do NEP users respond as they encounter this process? 2. What are the sources of needles brought to the NEP and the distribution patterns of needles once they leave an NEP? 3. Do NEPs make a difference in IDUs' risk behaviors, use of drug treatment and other services, and rate of HIV infection? 4. What variations in NEP operations are associated with greater effectiveness in achieving desired outcomes? Our study design combines: (a) two NEPs to serve as comparison treatment conditions: """"""""standard"""""""" and """"""""enhanced"""""""" (b) ethnographic and systematic observational study of these NEP operations (c) ethnographic study of NEP-users' and non-users' injection behaviors with a particular emphasis on the role of risk networks (d) a longitudinal survey of three groups of IDUs: one that uses a standard-NEP, one that uses an enhanced-NEP, and one from a community area without an NEP, to assess individual-level impacts of variations in NEP on risk behaviors, entrance to drug treatment and other services, and HIV infection.
| Huo, Dezheng; Ouellet, Lawrence J (2009) Needle exchange and sexual risk behaviors among a cohort of injection drug users in Chicago, Illinois. Sex Transm Dis 36:35-40 |
| Huo, Dezheng; Ouellet, Lawrence J (2007) Needle exchange and injection-related risk behaviors in Chicago: a longitudinal study. J Acquir Immune Defic Syndr 45:108-14 |
| Huo, Dezheng; Bailey, Susan L; Ouellet, Lawrence J (2006) Cessation of injection drug use and change in injection frequency: the Chicago Needle Exchange Evaluation Study. Addiction 101:1606-13 |
| Huo, Dezheng; Bailey, Susan L; Hershow, Ronald C et al. (2005) Drug use and HIV risk practices of secondary and primary needle exchange users. AIDS Educ Prev 17:170-84 |
| Ouellet, Lawrence; Huo, Dezheng; Bailey, Susan L (2004) HIV risk practices among needle exchange users and nonusers in Chicago. J Acquir Immune Defic Syndr 37:1187-96 |
