A program that is only partially effective in

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A program that is only partially effective in preventing the sharing of contaminated injection equipment could have the net effect of increasing AIDS deaths if it also boosts the number of injection drug users . Furthermore, opponents say, making sterile needles and syringes more readily available would not eliminate sharing. And they take issue with research findings that support needle exchange.24 They cite evidence that attributes needle sharing to a variety of cultural and psychological factors, in addition to convenience and economy HIV rates are empirically higher in those who attend NEP, Vlahov writes: The Role of Needle Exchange Programs in HIV Prevention Author(s): David Vlahov and Benjamin Junge Source: Public Health Reports (1974-), Vol. 113, Supplement 1: HIV Prevention with Drug- Using Populations: Current Status and Future Prospects (Jun., 1998), pp. 75-80 Published by: Association of Schools of Public Health Vlahov In February 1997, a research group in Vancouver presented results at a scientific meeting of a sharp increase in HIV prevalence among injection drug users, despite the long-time existence of a local needle exchange program; this report was subsequently published (30). Unpublished reports were also circulating of a study in Montreal in which the incidence of HIV was considerably higher in needle exchange program attendees than non-attendees; this report was subsequently published (31). That same month, a National Institutes of Health consensus panel reviewed studies on needle exchange programs, including the Canadian data from Montreal and Vancouver (which at the time were unpublished but made accessible), and concluded that “legislative restriction on needle exchange programs must be lifted” (32). The resulting National Institutes of Health Consensus Statement on Interventions to Prevent HIV Risk Behaviors was released in March 1997. Syringe Programs have proven to be inaccessible to the public Jarlais Writes: Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs Don C. Des Jarlais, PhD, Denise Paone, EdD, Samuel R. Friedman, PhD, Nina Peyser, MBA, and Robert G. Newman, MD Discretion is an important part of valor. Syringe exchange sites need to be located where drug injectors can access them conveniently; this will often be in areas where drugs are sold. Siting decisions should , however, give preference to multiple sites, long hours of operation, and the provision of private spaces for meetings of injection drug users . As noted earlier , the restrictive regulations on methadone programs have often led to large numbers of patients frequently attending a single site, followed by visible congregations of patients in the area and intense community relations problems. While drug users have not necessarily forfeited their constitutional right to freedom of assembly, it would still be wise to locate sites and schedule hours of operation in such a way as to minimize visible congregations of drug users near syringe exchange programs.
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