What is needle exchange?

According to the Centers for Disease Prevention and Control, as many as 900,000 Americans are infected with HIV, the virus that causes AIDS.¹ Needle exchange is one way to prevent HIV infection in injection drug users (IDUs), their sexual partners, and their unborn children. In a needle exchange program, IDUs exchange used syringes for new, sterile ones.

Needle exchange programs are based on a sound public health principle: eliminating the item that helps transmit infection from one person to another. Needle exchange discourages re-use of dirty needles and reduces the number of syringes discarded in public places, like parks and playgrounds. Outreach workers in a needle exchange program can also link IDUs to drug treatment, HIV testing, primary medical care, and tuberculosis or sexually transmitted disease screening.

Why do we need needle exchange?

There are more than one million people in the United States who inject drugs. People who inject drugs are at high risk of contracting HIV if they share needles. If they contract HIV, their needle-sharing partners, sexual partners and unborn children may also become infected.

In Oregon, IDUs are the second largest group of people with AIDS (20 percent of all cases). Injection drug use is responsible for 33 percent of all AIDS cases in women.² Thirty-six percent of the children with AIDS in Oregon are the children of IDUs.

How does needle exchange reduce the spread of HIV?

Getting injectors off drugs is the best way to reduce the risk of transmission of HIV during needle use. In addition to providing a source of sterile needles, needle exchange programs can link IDUs with drug treatment. Also, the personal contact involved in needle exchange provides an opportunity to educate about HIV risks, distribute condoms or brochures, and offer HIV testing.

Does needle exchange encourage drug use?

There is NO evidence that needle exchange programs increase the amount of drug use by clients or in the wider community. A five-year study of a San Francisco needle exchange program found that frequency of injecting drugs among IDUs declined from 1.9 to 0.7 injections per day. Drug abuse and the recruitment of new or younger users did not increase in the presence of the exchange.³  Other studies around the world have found similar results.

Why do drug users share needles?

Many IDUs are aware of the risk of HIV infection if they use contaminated equipment. However, there are often not enough syringes to go around when several people are injecting together. And, although it is legal to buy syringes over-the-counter in Oregon, pharmacists are often unwilling to sell to people who cannot verify that they have a medical condition. Also, sharing with a friend or partner is sometimes part of the ritual of shooting drugs.

Is needle exchange cost effective?

Yes. Mathematical models predict that over five years, needle exchanges could prevent HIV infection among clients, their sex partners, and their unborn children at a cost of about $9,400 per infection prevented. This is far below the $119,000 lifetime average cost of treating an infected person.⁴

Why is the health department doing needle exchange?

In Multnomah County, the health department is committed to doing whatever we can to build healthy communities. Our mission is to “assure, promote and protect the health of the people of Multnomah County.”

One of the Oregon Benchmarks is to stabilize and reduce HIV cases in our state. Multnomah County Health Department already uses outreach, counseling, testing, trainings and distribution of educational materials to prevent HIV from spreading further into our community. Needle exchange will give us one more tool to stem the tide of this epidemic.

Important Information for Intravenous (IV) Drug Users

Needle exchange schedule: English | Spanish

Footnotes:

Frequently Asked Questions (CDC site) | Myths and Facts about AIDS | Testing Sites | Community Planning Team | CPT Plan (PDF) | Needle Exchange | What's Working in Needle Exchange | Needle Exchange Schedule: English Spanish | Reducing Risk when Injecting Drugs | How to Use a Condom