How otherwise dedicated AIDS prevention workers come to support state-sponsored shortage of clean syringes in Vancouver, Canada

• Published in: The International journal of drug policy Vol. 15; no. 1; pp. 36 - 45
• Main Authors: Spittal, P.M, Small, W, Wood, E, Johnston, C, Charette, J, Laliberté, N, O’Shaughnessy, M.V, Schechter, M.T
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-02-2004
• Subjects: Canada; HIV; Intravenous drug addicts; Needle exchange schemes; Policy; Prevention; Single room occupancy; State intervention; Syringes; Unmet needs; Vancouver; HIV; Single room occupancy; Syringes
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/S0955-3959(03)00132-4

Vancouver continues to experience an ongoing HIV outbreak among injection drug users despite the presence of North America’s largest needle exchange programme. The present study utilizes ethnographic interviews and observations conducted with fixed site and mobile van ‘exchange agents’ to examine access to sterile syringes by IDUs in Vancouver between May 2000 and March 2001. Point-for-point exchange continues to be the dominant policy. Ethnographic evidence suggests that there is a large demand for sterile syringes (‘rigs’) when users do not have any to return, indicating policy/practice discrepancies. Despite policy, an intricate rig loaning system has evolved out of agreements made between needle exchange agents and their clients. Restrictive syringe exchange policies lead to considerable unmet needs among injection drug users. Policy makers must change their policies to better address issues of syringe access and in consultation with user groups, develop alternative models of needle distribution and recovery that do not necessarily include exchange.