US NEEDLE-EXCHANGE PROGRAMS DECLINING

A recently released report showed a decline in needle-exchange
programs in the United States and a diminution of public funding for
such programs. In 2003, Dr. C.A. McKnight of New York's Beth Israel
Medical Center and colleagues conducted surveys of 148
needle-exchange programs known to the North American Syringe Exchange Network.

"In 2002, for the first time in 8 years, the number of exchange
programs, the number of localities with exchange programs, and the
amount of public funding for exchange programs in the United States
decreased," the authors noted in the July 15 issue of CDC's Morbidity
and Mortality Weekly Report.

The number of needle-exchange programs declined from 154 in 2000 to
148 in 2002, the researchers found, primarily through loss of small
programs. The number of states and territories with exchange programs
fell from 35 to 32; public funding decreased 18 percent. At the same
time, the number of syringes exchanged increased 20.2 percent and
total budgets grew 7.4 percent.

In addition to providing injection drug users (IDUs) with sterile
syringes and safely disposing of used syringes, exchange programs
offer social services such as condom provision, substance-abuse
treatment referral, and HIV, and hepatitis testing. Such programs,
"provide health and social services to IDUs who might not otherwise
be reached," the authors concluded. "Continued monitoring of exchange
programs in the United States is necessary to evaluate the long-term
effects of this public health intervention."

The full report, "Update: Syringe Exchange Programs - United States,
2002," was published in Morbidity and Mortality Weekly Report
(2005;54(27):673-676).