Is there a risk that needle/syringe exchange programmes might “send the wrong message” and result in more injecting drug use?
The evidence does not support this view. Studies conducted in Australia, Canada, Sweden, the UK and the USA have all shown that needle/syringe exchange programmes—particularly when carried out in concert with other interventions— help reduce the sharing of injecting equipment and the transmission of HIV. There was no evidence that needle exchange programmes increased either the number of people using drugs or the frequency of injecting drug use. When clean-needle services were offered in California in the 1990s, the percentage of new initiates into injecting drug use fell (from 3% to 1%), regular users injected less frequently, and needle-sharing decreased by more than 70%. A global review of clean-needle/syringe programmes implemented between 1988 and 1993 found that, in 29 cities with needle-exchange programmes, HIV prevalence among injecting drug users fell by an average of 5.8% a year, and the number of users did not increase. In contrast, in 52 cities lacking such programmes, HIV
