Structural impediments to operational syringe-exchange programs

AIDS and Public Policy Journal

Volumn 11, Issue 4, 1996, Pages 169-184

  Heimer, Robert ^a   Bluthenthal, Ricky N ^b   Singer, Merrill ^c   Khoshnood, Kaveh ^a  

^a YALE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b UNIVERSITY OF CALIFORNIA   (United States)

^c HISPANIC HEALTH COUNCIL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

FINANCE; HEALTH PROGRAM; HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; INTRAVENOUS DRUG ABUSE; LEGAL ASPECT; MANAGED CARE; POLITICS; REVIEW; SYRINGE; VIRUS TRANSMISSION;

CONNECTICUT; HIV INFECTIONS; HUMANS; MANAGED CARE PROGRAMS; NEEDLE-EXCHANGE PROGRAMS; POLITICS; PUBLIC POLICY; SOCIAL ENVIRONMENT; SUBSTANCE ABUSE, INTRAVENOUS; UNITED STATES;

EID: 0030431742     PISSN: 08873852     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (92)

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3. H. Grosskurth et al., "Impact of Improved Treatment of Sexually Transmitted Diseases on HIV Infection in Rural Tanzania: Randomized Control Trial," Lancet 346 (1995): 530-36; R.S. Hanenberg et al., "Impact of Thailand's HIV-Control Programme as Indicated by the Decline of Sexually Transmitted Diseases," Lancet 344 (1994): 243-45; D.S. Metzger et al., "Human Immunodeficiency Virus Seroconversion Among Intravenous Drug Users In- and Out-of-Treatment: An 18-Month Prospective Follow-up" Journal of Acquired Immune Deficiency Syndromes 6 (1993): 1049-56; S.L. Groseclose et al., "Impact of Increased Legal Access to Needles and Syringes on Practices of Injecting-Drug Users and Police Officers-Connecticut, 1992-1993," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 10 (1995): 82-89.
4. H. Grosskurth et al., "Impact of Improved Treatment of Sexually Transmitted Diseases on HIV Infection in Rural Tanzania: Randomized Control Trial," Lancet 346 (1995): 530-36; R.S. Hanenberg et al., "Impact of Thailand's HIV-Control Programme as Indicated by the Decline of Sexually Transmitted Diseases," Lancet 344 (1994): 243-45; D.S. Metzger et al., "Human Immunodeficiency Virus Seroconversion Among Intravenous Drug Users In- and Out-of-Treatment: An 18-Month Prospective Follow-up" Journal of Acquired Immune Deficiency Syndromes 6 (1993): 1049-56; S.L. Groseclose et al., "Impact of Increased Legal Access to Needles and Syringes on Practices of Injecting-Drug Users and Police Officers-Connecticut, 1992-1993," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 10 (1995): 82-89.
5. An International Conference on Health Promotion, The Ottawa Charter (Ottawa, Ont., Canada: International Conference on Health Promotion sponsored by the World Health Organization, Welfare Canada, and the Canadian Public Health Association in November 1986).
6. J.M. Pates, "The Effects of Policy-Making on Harm Reduction: Whose Problem?" International Journal of Drug Policy 6 (1995): 39-45.
7. D.C. Des Jarlais et al., "Maintaining Low HIV Seroprevalence in Populations of Injecting Drug Users," Journal of the American Medical Association 274 (1995): 1226-31.
8. K-H Choi and T.J. Coates, "Prevention of HIV Infection," AIDS 8 (1994): 1371-89.
9. R. Heimer et al., "Three Years of Needle Exchange in New Haven: What Have We Learned?" AIDS & Public Policy Journal 9, no. 2 (Summer 1994): 59-74.
10. P. Lurie et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad (San Francisco, Calif.: University of California and the Centers for Disease Control and Prevention, 1993); J. Normand, D. Vlahov, and L.E. Moses, Preventing HIV Transmission: The Role of Sterile Needles and Bleach (Washington, D.C.: National Research Council/Institute of Medicine, National Academy Press, 1995).
11. P. Lurie et al., The Public Health Impact of Needle Exchange Programs in the United States and Abroad (San Francisco, Calif.: University of California and the Centers for Disease Control and Prevention, 1993); J. Normand, D. Vlahov, and L.E. Moses, Preventing HIV Transmission: The Role of Sterile Needles and Bleach (Washington, D.C.: National Research Council/Institute of Medicine, National Academy Press, 1995).
12. M. Donoghoe et al., "Changes in HIV Risk Behavior in Clients of Syringe-Exchange Schemes in England and Scotland," AIDS 3 (1989): 267-72; E.J. van Ameijden et al., "The Harm Reduction Approach and Risk Factors for HIV Seroconversion in Injecting Drug Users, Amsterdam," American Journal of Epidemiology 136 (192): 236-43; J.K. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-20.
13. M. Donoghoe et al., "Changes in HIV Risk Behavior in Clients of Syringe-Exchange Schemes in England and Scotland," AIDS 3 (1989): 267-72; E.J. van Ameijden et al., "The Harm Reduction Approach and Risk Factors for HIV Seroconversion in Injecting Drug Users, Amsterdam," American Journal of Epidemiology 136 (192): 236-43; J.K. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-20.
14. M. Donoghoe et al., "Changes in HIV Risk Behavior in Clients of Syringe-Exchange Schemes in England and Scotland," AIDS 3 (1989): 267-72; E.J. van Ameijden et al., "The Harm Reduction Approach and Risk Factors for HIV Seroconversion in Injecting Drug Users, Amsterdam," American Journal of Epidemiology 136 (192): 236-43; J.K. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-20.
15. E.H. Kaplan, "Evaluating Needle Exchange Programs via Syringe Tracking and Testing," AIDS & Public Policy Journal 6, no. 3 (Fall 1991): 109-15.
16. E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; R. Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1 Proviral DNA in Returned Syringe in New Haven, CT," American Journal of Medicine 95 (1993): 214-20.
17. E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; R. Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1 Proviral DNA in Returned Syringe in New Haven, CT," American Journal of Medicine 95 (1993): 214-20.
18. A.A. Gleghorn et al., "Needle/Syringe Sources, Reuse, and Opinions Toward 'One Shot, One Set' Among Active Injection Drug Users in Six US Cities," (Paper delivered at the 11th International Conference on AIDS, Vancouver, B.C., Canada, 1996), abstract no. Mo.D.365; R. Heimer et al., "Syringe Use and Re-Use: Effects of Syringe Exchange Programs in Four Cities," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (1997, in press).
19. A.A. Gleghorn et al., "Needle/Syringe Sources, Reuse, and Opinions Toward 'One Shot, One Set' Among Active Injection Drug Users in Six US Cities," (Paper delivered at the 11th International Conference on AIDS, Vancouver, B.C., Canada, 1996), abstract no. Mo.D.365; R. Heimer et al., "Syringe Use and Re-Use: Effects of Syringe Exchange Programs in Four Cities," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (1997, in press).
20. E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
21. E.H. Kaplan, "Operational Modeling of Needle Exchange Programs," in Workshop on Needle Exchange and Bleach Distribution Programs (Washington, D.C.: National Academy Press, 1994), 202-49; D.C. Des Jarlais et al., "HIV Incidence Among Injecting Drug Users in New York City Syringe-Exchange Programmes," Lancet 348 (1996): 987-91 .
22. E.H. Kaplan, "Operational Modeling of Needle Exchange Programs," in Workshop on Needle Exchange and Bleach Distribution Programs (Washington, D.C.: National Academy Press, 1994), 202-49; D.C. Des Jarlais et al., "HIV Incidence Among Injecting Drug Users in New York City Syringe-Exchange Programmes," Lancet 348 (1996): 987-91 .
23. R. Heimer and M. Lopes, "Syringe and Needle Exchange to Prevent HIV Infection" (letter), Journal of the American Medical Association 271 (1994): 1825-26.
24. For reviews on this topic, please see P. Brickner et al., "Recommendations for Control and Prevention of Human Immunodeficiency Virus (HIV) Infection in Intravenous Drug Users," Annals of Internal Medicine 110 (1989): 833-37; R.P. Brettle, "HIV and Harm Reduction for Injection Drug Users," AIDS 5 (1991): 125-36; J. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-
25. For reviews on this topic, please see P. Brickner et al., "Recommendations for Control and Prevention of Human Immunodeficiency Virus (HIV) Infection in Intravenous Drug Users," Annals of Internal Medicine 110 (1989): 833-37; R.P. Brettle, "HIV and Harm Reduction for Injection Drug Users," AIDS 5 (1991): 125-36; J. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-
26. For reviews on this topic, please see P. Brickner et al., "Recommendations for Control and Prevention of Human Immunodeficiency Virus (HIV) Infection in Intravenous Drug Users," Annals of Internal Medicine 110 (1989): 833-37; R.P. Brettle, "HIV and Harm Reduction for Injection Drug Users," AIDS 5 (1991): 125-36; J. Watters et al., "Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users," Journal of the American Medical Association 271 (1994): 115-
27. D.C. Des Jarlais et al., "Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs," American Journal of Public Health 85 (1995): 1577-84; O. Tawil, A. Verster, and K.R. O'Reilly, "Enabling Approaches for HIV/AIDS Prevention: Can We Modify the Environment and Minimize the Risk?" AIDS 9 (1995): 1299-1306.
28. D.C. Des Jarlais et al., "Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs," American Journal of Public Health 85 (1995): 1577-84; O. Tawil, A. Verster, and K.R. O'Reilly, "Enabling Approaches for HIV/AIDS Prevention: Can We Modify the Environment and Minimize the Risk?" AIDS 9 (1995): 1299-1306.
29. M.V. Nadel, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy (Washington, D.C.: U.S. General Accounting Office, 1993 No. GAO/HRD-93-60); Lurie et al., "The Public Health Impact of Needle Exchange Programs," see note 7 above; The Effectiveness of AIDS Prevention Efforts (Washington, D.C.: Office of Technology Assessment, No. OTC-95-56); Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above; Consensus Development Statement: Interventions to Prevent HIV Risk Behaviors (Bethesda, Md.: National Institutes of Health, 1997, Consensus Development Conference #104).
30. M.V. Nadel, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy (Washington, D.C.: U.S. General Accounting Office, 1993 No. GAO/HRD-93-60); Lurie et al., "The Public Health Impact of Needle Exchange Programs," see note 7 above; The Effectiveness of AIDS Prevention Efforts (Washington, D.C.: Office of Technology Assessment, No. OTC-95-56); Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above; Consensus Development Statement: Interventions to Prevent HIV Risk Behaviors (Bethesda, Md.: National Institutes of Health, 1997, Consensus Development Conference #104).
31. M.V. Nadel, Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy (Washington, D.C.: U.S. General Accounting Office, 1993 No. GAO/HRD-93-60); Lurie et al., "The Public Health Impact of Needle Exchange Programs," see note 7 above; The Effectiveness of AIDS Prevention Efforts (Washington, D.C.: Office of Technology Assessment, No. OTC-95-56); Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above; Consensus Development Statement: Interventions to Prevent HIV Risk Behaviors (Bethesda, Md.: National Institutes of Health, 1997, Consensus Development Conference #104).
32. Office of National Drug Control Policy, Needle Exchange Programs: Are They Effective? (Washington, D.C.: U.S. Office of National Drug Control Policy, 1992).
33. S. Burris et al., "The Legal Strategies Used in Operating Syringe Exchange Programs in the United States," American Journal of Public Health 86 (1996): 1161-66.
34. Lurie et al., The Public Health Impact, see note 7 above; Burris et al., "The Legal Strategies," see note 18 above.
35. Lurie et al., The Public Health Impact, see note 7 above; Burris et al., "The Legal Strategies," see note 18 above.
36. See note 18 above.
37. D. Paone et al., "Syringe Exchange Programs-United States 1994-1995," Morbidity and Mortality Weekly Report 44 (1995): 684-85.
38. SEP volunteers have been arrested in the following cities and states: Berkeley, Los Angeles, Monterey, Oakland, Redwood City, San Diego, San Francisco, and Santa Cruz, Calif.; Wilmington, Del.; Chicago, Ill.; Boston, Lowell, Lynn, and Worcester, Mass.; Buffalo and New York City, N.Y.; Jersey City and New Brunswick, N.J.; Nashua and Manchester, N.H.; and in Rhode Island.
39. See note 18 above.
40. R.N. Bluthenthal, A.H. Kral, and J.K. Watters, "Impact of Law Enforcement on Syringe Exchange Programs," Medical Anthropology (1997, in press).
41. Bluthenthal, Kral, and Walters, "Impact of Law Enforcement," ibid.; R.N. Bluthenthal, A.H. Kral, and J. Lorvick, "Risk Behavior Among Clients of Tolerated and Underground Syringe Exchanges in the San Francisco Bay Area," (Paper delivered at the 11th International Conference on AIDS, Vancouver, B.C., Canada 1996), abstract no. We.C.3559.
42. Bluthenthal, Kral, and Walters, "Impact of Law Enforcement," ibid.; R.N. Bluthenthal, A.H. Kral, and J. Lorvick, "Risk Behavior Among Clients of Tolerated and Underground Syringe Exchanges in the San Francisco Bay Area," (Paper delivered at the 11th International Conference on AIDS, Vancouver, B.C., Canada 1996), abstract no. We.C.3559.
43. Ibid.
44. B.R. Edlin et al., "Intersecting Epidemics-Crack Cocaine Use and HIV Infection Among Inner-City Young Adults", New England Journal of Medicine 331 (1994): 1422-27.
45. Kaplan and Heimer, "A Circulation Theory," see note 10 above.
46. See note 21 above.
47. T. Kingston, "Needle Exchange Meets a New Obstacle: No Money for Needles," Express (Oakland/East Bay, Calif.), 14 June 1996, 3, 25-26.
48. Lurie et al., The Public Health Impact, see note 7 above.
49. See notes 21 and 24 above.
50. R. Cain, "Community-Based AIDS Services: Formalization and Depoliticalization," International Journal of Health Services 23 (1993): 665-84.
51. S. Morgan, "The Dynamics of Co-Optation in a Feminist Health Clinic," Social Science and Medicine 23 (1986): 201-10; M. Singer, "The Evolution of AIDS Work in a Puerto Rican Community Organization," Human Organization 55 (1996): 67-75.
52. S. Morgan, "The Dynamics of Co-Optation in a Feminist Health Clinic," Social Science and Medicine 23 (1986): 201-10; M. Singer, "The Evolution of AIDS Work in a Puerto Rican Community Organization," Human Organization 55 (1996): 67-75.
53. M. Singer, R. Irizarry, and J. Schensul, "Needle Access as an AIDS Prevention Strategy for IV Drug Users: A Research Perspective," Human Organization 50 (1991): 142-53.
54. These views were expressed by the chief of police at a citywide conference on AIDS prevention held at Trinity College, Hartford, in March 1990 in a debate which included the third author.
55. The third author was a participant in the meeting, which took place in 1989.
56. M. Singer et al., "Ethnography and the Evaluation of Needle Exchange in the Prevention of HIV Transmission," in Qualitative Methods in Drug Abuse and HIV Research, E.Y. Lambert, R.S. Ashery, and R.H. Needle, ed. (Rockville, Md.: NIDA Research Monograph 157, 1995), 231-57.
57. M. Singer, M.R. Weeks, and D. Himmelgreen, "Sale and Exchange of Syringes," Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 10 (1995): 104.
58. "Hartford Restricts Social Services to Stem the Flow of Poor People," New York Times 14 August 1996.
59. For example, F. Spencer-Molloy, "Laws Reduce Needle Sharing: Addicts' Changes in Behavior May Slow AIDS Spread," Hartford Courant, 30 August 1995.
60. J. Rabinovitz, "Fighting Poverty Programs: Hartford Faces Vote to Bar New Nonprofit Services," New York Times, 24 March 1996.
61. Ibid.
62. These issues were discussed in a meeting between the Community Alliance for AIDS Programs and the State of Connecticut Health Department in May 1996.
63. Findings of the Hartford Needle Exchange Evaluation Project, a research study funded by the National Institute of Drug Abuse; the third author is the principal investigator.
64. Ibid.
65. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
66. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
67. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
68. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
69. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
70. E. O'Keefe, E.H. Kaplan, and K. Khoshnood, Preliminary Report: City of New Haven Needle Exchange Program (New Haven, Conn.: City of New Haven, 1991); Kaplan, "Evaluating Needle Exchange Programs," see note 9 above; Heimer et al., "Needle Exchange Decreases the Prevalence of HIV-1," see note 10 above; E.H. Kaplan and R. Heimer, "HIV Incidence among Needle Exchange Participants: Estimates from Syringe Tracking and Testing," Journal of Acquired Immuno Deficiency Syndromes 7 (1994): 182-89; E.H. Kaplan and R. Heimer, "A Circulation Theory of Needle Exchange," AIDS 8 (1994): 567-74; E.H. Kaplan, "A Method for Evaluating Needle Exchange Programmes," Statistics in Medicine 13 (1994): 2179-87.
71. Groseclose et al., "Impact of Increased Legal Access," see note 1 above.
72. See notes 6 and 9 above.
73. K. Khoshnood, Client-Based Evaluation of New Haven's Needle Exchange Program (PhD diss., Yale University, New Haven, Conn., 1995).
74. See note 6 above.
75. E.H. Kaplan and D. Soloshatz, "How Many Drug Injectors Are There in New Haven? Answers from AIDS Data," Mathematical and Computer Modeling 17 (1993): 109-15.
76. Nadel, "Needle Exchange Programs," see note 16 above; Lurie et al., The Public Health Impact, see note 7 above; Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above.
77. Nadel, "Needle Exchange Programs," see note 16 above; Lurie et al., The Public Health Impact, see note 7 above; Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above.
78. Nadel, "Needle Exchange Programs," see note 16 above; Lurie et al., The Public Health Impact, see note 7 above; Normand, Vlahov, and Moses, "Preventing HIV Transmission," see note 7 above.
79. S.N. Tesh, Hidden Arguments: Political Ideology and Disease Prevention Policy (New Brunswick, N.J.: Rutgers University Press, 1988).
80. See note 2 above.
81. See note 15 and 16 above for a partial list of review papers and governmental reports on this subject.
82. D. Thompson, "Getting the Point in New Haven," Time, 25 May 1992, 55; M. Rath, "Baltimore Plan Urges Aiding Drug Addicts to Stem Crime," Reuters News Service, NEXUS, 1 December 1993.
83. D. Thompson, "Getting the Point in New Haven," Time, 25 May 1992, 55; M. Rath, "Baltimore Plan Urges Aiding Drug Addicts to Stem Crime," Reuters News Service, NEXUS, 1 December 1993.
84. Groseclose et al., "Impact of Increased Legal Access," see note 1 above.
85. W. Anderson, "The New York Needle Trial: The Politics of Public Health in the Age of AIDS," American Journal of Public Health 81 (1991): 1506-17; D. Vlahov et al., "A Pilot Syringe Exchange Program in Washington, DC," American Journal of Public Health 84 (1994): 303-04; D.C. Des Jarlais et al., "Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs," American Journal of Public Health 85 (1995): 1577-84.
86. W. Anderson, "The New York Needle Trial: The Politics of Public Health in the Age of AIDS," American Journal of Public Health 81 (1991): 1506-17; D. Vlahov et al., "A Pilot Syringe Exchange Program in Washington, DC," American Journal of Public Health 84 (1994): 303-04; D.C. Des Jarlais et al., "Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs," American Journal of Public Health 85 (1995): 1577-84.
87. W. Anderson, "The New York Needle Trial: The Politics of Public Health in the Age of AIDS," American Journal of Public Health 81 (1991): 1506-17; D. Vlahov et al., "A Pilot Syringe Exchange Program in Washington, DC," American Journal of Public Health 84 (1994): 303-04; D.C. Des Jarlais et al., "Regulating Controversial Programs for Unpopular People: Methadone Maintenance and Syringe Exchange Programs," American Journal of Public Health 85 (1995): 1577-84.
88. L.O. Gostin et al., "Prevention of HIV/ AIDS Among Injection Drug Users: A National Survey on the Regulation of Syringes and Needles," Journal of the American Medical Association 277 (1997): 53-62.
89. W. Compton et al., "Legal Needle Buying in St. Louis," American Journal of Public Health 82 (1992): 595-96.
90. Singer, Irizarry, and Schensul, "Needle Access," see note 35 above; D.C. Des Jarlais et al., "Regulating Syringe Exchange: A Cautionary Note," Journal of the American Medical Association 272 (1994): 431-32.
91. Singer, Irizarry, and Schensul, "Needle Access," see note 35 above; D.C. Des Jarlais et al., "Regulating Syringe Exchange: A Cautionary Note," Journal of the American Medical Association 272 (1994): 431-32.
92. F.R. Steele, "Needle-Exchange Program Debate Gets Pointed," Nature & Medicine 2 (1996): 261.