First Advisor

Jerry Lansdowne

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Urban Studies


Urban Studies




Needle Exchange Program (Portland -- Or.), Needle exchange programs -- Oregon -- Portland, Behavior modification -- Oregon -- Portland



Physical Description

ix, 184 leaves 28 cm.


Research questions were: 1: Will Drug Injectors Use An Exchange In A StateWhere Syringes Are Legal? 2: Will Drug Injectors Using An Exchange Decrease Risky Behavior? 3: Will Frequent Clients Change Risk Behaviors More Than Infrequent Clients? 4: Will Drug Injectors Using An Exchange Change Risk Behaviors More Than A Comparison Group Not Using An Exchange? 5: Does An Exchange Have An Impact On The Number Of Discarded Syringes On The Streets? 6: Is There A Difference In The Rate Of Spread Of HIV Infection Among Users And Non-Users Of The Exchange. Drug injectors will use needle exchange programs, even in a state where syringes are legal. During the first four years, nearly 2,000 drug injectors made approximately 16,000 visits to the Exchange. Clients of the Exchange reduced risky behavior from intake to six months. Change lasted over time: at twelve months, change in behaviors continued to be significant. Frequent users of the Exchange were better on two variables than infrequent users: they borrowed syringes less, and were less likely to use a syringe and throw it away. Drug injectors using the Exchange were compared to those not using the Exchange, but using a bleach/outreach project. Clients of both projects reduced risky behaviors, with Exchange clients better on two variables: re-using syringes without cleaning, and throwing away used syringes. The two projects attracted different drug injectors, and should be viewed as complementary rather than competing AIDS prevention strategies. The impact of the Exchange on the community was evaluated by the change in the number of discarded syringes found on the streets. The number of syringes found per month decreased from 5.14 before the Exchange opened to 1.9 after it began -- a significant side benefit. The data presented here support the growing evidence that needle exchange programs produce behavioral risk reductions, and that the number of potentially infected syringes in public places can be reduced.


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