International Journal of Drug Policy
Volume 14, Issue 5 , Pages 417-424, December 2003

What predicts which metropolitan areas in the USA have syringe exchanges?

  • Barbara Tempalski

      Affiliations

    • National Development and Research Institutes, 71 West 23rd St., 8fl., New York, NY 10010, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1-212-845-4400; fax: +1-917-438-0894.
    • ,
  • Samuel R Friedman

      Affiliations

    • National Development and Research Institutes, 71 West 23rd St., 8fl., New York, NY 10010, USA
    • ,
  • Don C Des Jarlais

      Affiliations

    • Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, USA
    • Fax: +1-212-387-3897.
    • ,
  • Courtney McKnight

      Affiliations

    • Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003, USA
    • Fax: +1-212-387-3897.
    • ,
  • Marie Keem

      Affiliations

    • National Development and Research Institutes, 71 West 23rd St., 8fl., New York, NY 10010, USA
    • ,
  • Risa Friedman

      Affiliations

    • National Development and Research Institutes, 71 West 23rd St., 8fl., New York, NY 10010, USA

Received 1 December 2002; received in revised form 15 March 2003; accepted 24 June 2003.

Abstract 

HIV epidemics among IDUs vary widely across different cities in the USA [American Journal of Public Health 86 (5) (1996) 642]. Few studies have focused on how localities differ in regard to response to the HIV epidemic. While syringe exchange programmes (SEPs) are a response to HIV among IDUs, they are often unwelcome and difficult to set up even in communities hit hardest by the epidemic. It is important to understand what metropolitan area characteristics are related to when and if an SEP opens in a particular locality. Logistic regression models are used to explore how need, political factors, SEP diffusion from Tacoma (the first SEP), and metropolitan socioeconomic characteristics are related to SEP presence. Results indicate that need is not a significant predictor of having an SEP. Predictors were the percentage of the population who are men who have sex with men (AOR=6.95; 95% CI=1.29–37.49), and metropolitan area population (AOR=1.08 per 100,000; 95% CI=1.02–1.14). Predictors of having an SEP in a metropolitan area seem to be political factors and metropolitan area population size, not need among IDUs. Gay political influence and/or support may well facilitate SEP formation, and geographic diffusion may influence where SEPs are established.

Keywords:  Syringe exchange programmes, Place, Spatial variation, Predictors, HIV prevention, Activism

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PII: S0955-3959(03)00143-9

doi:10.1016/S0955-3959(03)00143-9

International Journal of Drug Policy
Volume 14, Issue 5 , Pages 417-424, December 2003

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