Needle exchange is not enough: lessons from the Vancouver injecting drug use study

@article{Strathdee1997NeedleEI,
  title={Needle exchange is not enough: lessons from the Vancouver injecting drug use study},
  author={Steffanie A. Strathdee and David Patrick and Sue L. Currie and Peter G. A. Cornelisse and Michael L. Rekart and Julio S. G. Montaner and Martin T Schechter and Michael V. O’Shaughnessy},
  journal={AIDS},
  year={1997},
  volume={11},
  pages={F59–F65}
}
Objective: To describe prevalence and incidence of HIV‐1, hepatitis C virus (HCV) and risk behaviours in a prospective cohort of injecting drug users (IDU). Setting: Vancouver, which introduced a needle exchange programme (NEP) in 1988, and currently exchanges over 2 million needles per year. Design: IDU who had injected illicit drugs within the previous month were recruited through street outreach. At baseline and semi‐annually, subjects underwent serology for HIV‐1 and HCV, and questionnaires… 
Do needle exchange programmes increase the spread of HIV among injection drug users?: an investigation of the Vancouver outbreak.
TLDR
No evidence is found that this NEP is causally associated with HIV transmission, and by attracting higher risk users, NEP may furnish a valuable opportunity to provide additional preventive/support services to these difficult-to-reach individuals.
Needle and syringe exchange programmes and prevalence of HIV infection among intravenous drug users in China.
TLDR
Participation in needle and syringe exchange programmes was associated with a substantially lower risk of HIV infection among intravenous drug users in China.
HIV Prevalence Remains Low Among Calgary’s Needle Exchange Program Participants
TLDR
HIV prevalence remains low among NEP attenders in Calgary, although high-risk behaviours are common and many IDU want to participate in addiction treatment, and strategies should be made to provide accessible, appropriate treatment services.
Syringe exchange and risk of infection with hepatitis B and C viruses.
TLDR
A cohort study among Seattle injection drug users to assess whether participation in a syringe exchange program was associated with incidence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection suggests that no such benefit occurred during the period of the study.
HIV Infection among Male Injecting Drug Users in Bangladesh 2125 Introduction
TLDR
Urgent measures must be undertaken to prevent escalation of the HIV epidemic in Bangladesh and homelessness was the only factor independently associated with HIV.
Requiring Help Injecting as a Risk Factor for HIV Infection in the Vancouver Epidemic
TLDR
Although current public health approaches, such as needle exchange, are unable to address the concerns associated with requiring help injecting, available evidence suggests that safer injecting facilities have the potential to substantially mitigate this risk behaviour.
Frequent needle exchange use and HIV incidence in Vancouver, Canada.
Requiring Help Injecting Independently Predicts Incident HIV Infection Among Injection Drug Users
TLDR
The need for interventions to reduce the risk of HIV infection among IDUs who require help injecting is demonstrated, and being aboriginal and requiring help injecting remained independent predictors of HIV seroconversion.
Prevalence of Infections, HIV Risk Behaviors and Factors Associated with HIV Infection Among Male Injecting Drug Users Attending a Needle/Syringe Exchange Program in Dhaka, Bangladesh
TLDR
Urgent measures must be undertaken to prevent escalation of the HIV epidemic in Bangladesh and homelessness was the only factor independently associated with HIV.
Seroprevalence and correlates of HIV and HCV among injecting drug users in Edmonton, Alberta.
TLDR
The high HIV and HCV prevalence found in this study among IDUs in Edmonton highlights the complex needs of the IDU community and the continued need for targeted programming.
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References

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TLDR
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TLDR
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TLDR
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