Abstract
This study examines trends of injection drug users’ (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia’s SEP registration data were analyzed using linear regression, Pearson’s Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.
Similar content being viewed by others
References
MacNeil J, Pauly B. Needle exchange as a safe haven in an unsafe world. Drug Alcohol Rev. 2011;30(1):26–32.
Hagan H, McGough JP, Thiede H, Hopkins S, Duchin J, Alexander ER. Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors. J Subst Abuse Treat. 2000;19(3):247–52.
Schoenbaum EE, Hartel DM, Gourevitch MN. Needle exchange use among a cohort of injecting drug users. AIDS. 1996;10(14):1729–34.
Des Jarlais DC, Nugent A, Solberg A, Feelemyer J, Mermin J, Holtzman D. Syringe service programs for persons who inject drugs in urban, suburban, and rural areas—United States, 2013. Morb Mortal Wkly Rep. 2015;64(48):1337–41.
Centers for Disease Control and Prevention. Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services. Morb Mortal Wkly Rep. 2012;61(RR05):1–40.
Armstrong GL. Injection drug users in the United States, 1979–2002: an aging population. Arch Intern Med. 2007;167(2):166–73.
Riley D, O’Hare P. Harm reduction: history, definition, and practice. In: Inciardi JA, Harrison LD, editors. Harm reduction: national and international perspectives. Thousand Oaks: SAGE Publications, Inc.; 2000.
Collins SE, Clifasefi SL, Logan DE, Samples LS, Somers JM, Marlatt GA. Current status, historical highlights, and basic principles of harm reduction. In: Marlatt GA, Larimer ME, Witliewitz K, editors. Harm reduction: pragmatic strategies for managing high-risk behaviors. 2nd ed. New York: Guilford Press; 2012.
Bramson H, Des Jarlais DC, Arasteh K, Nugent A, Guardino V, Feelemyer J, et al. State laws, syringe exchange, and HIV among persons who inject drugs in the United States: history and effectiveness. J Public Health Policy. 2015;36(2):212–30.
Hilton BA, Thompson R, Moore-Dempsey L, Janzen RG. Harm reduction theories and strategies for control of human immunodeficiency virus: a review of the literature. J Adv Nurs. 2001;33(3):357–70.
City of Philadelphia. Executive Order No. 4-92. http://www.phila.gov/ExecutiveOrders/Executive%20Orders/4-92.pdf. Accessed 5 Mar 2015.
AIDS Activities Coordinating Office. Newly-diagnosed HIV disease (regardless of AIDS status) by year and selected characteristics, Philadelphia residents, 1988–1992. Philadelphia, PA; 2015.
Prevention Point Philadelphia. Prevention Point Philadelphia. http://ppponline.org/. Accessed 5 Mar 2015.
Des Jarlais DC, Perlis T, Arasteh K, Torian LV, Hagan H, Beatrice S, et al. Reductions in hepatitis C virus and HIV infections among injecting drug users in New York City, 1990–2001. AIDS. 2005;19(Suppl 3):S20–5.
Fisher DG, Reynolds GL, Harbke CR. Selection effect of needle exchange in Anchorage, Alaska. J Urban Health. 2002;79(1):128–35.
Hahn JA, Vranizan KM, Moss AR. Who uses needle exchange? A study of injection drug users in treatment in San Francisco, 1989–1990. J Acquir Immune Defic Syndr Hum Retrovirol. 1997;15(2):157–64.
Chatterjee S, Tempalski B, Pouget ER, Cooper HLF, Cleland CM, Friedman SR. Changes in the prevalence of injection drug use among adolescents and young adults in large U.S. metropolitan areas. AIDS Behav. 2011;15(7):1570–8.
Klevens RM, Jones SE, Ward JW, Holtzman D, Kann L. Trends in injection drug use among high school students, U.S., 1995–2013. Am J Prev Med. 2016;50(1):40–6.
U.S. Census Bureau. Profile of general population and housing characteristics: 2010 demographic profile data, Philadelphia County. 2010 Census. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF. Accessed 18 July 2015.
U.S. Census Bureau. Profile of general demographic characteristics: Census 2000 summary file 1 (SF 1) 100-percent data, Philadelphia County. Census 2000. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmK. Accessed 18 July 2015.
U.S. Census Bureau. Profile of general demographic characteristics: Census 2000 summary file 1 (SF 1) 100-percent data, ZITA 19104. Census 2000. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmK. Accessed 18 July 2015.
U.S. Census Bureau. Profile of general population and housing characteristics: 2010 demographic profile data, ZITA 19104. 2010 Census. http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmK. Accessed 18 July 2015.
Pouget ER, Friedman SR, Cleland CM, Tempalski B, Cooper HLF. Estimates of the population prevalence of injection drug users among hispanic residents of large US metropolitan areas. J Urban Health. 2012;89(3):527–64.
Deren S, Kang S-Y, Colón HM, Robles RR. The Puerto Rico–New York airbridge for drug users: description and relationship to HIV risk behaviors. J Urban Health. 2007;84(2):243–54.
Shpaner M, Brady KA, Eberhart M. AIDS Activities Coordinating Office (AACO) Surveillance Report, 2013. Philadelphia, PA; 2014. http://www.phila.gov/health/pdfs/AACO2013SurveillanceReportFinal-dt.pdf. Accessed 2 Sept 2015.
Philadelphia Department of Public Health, Division of Disease Control. 2000 Annual Report. Philadelphia, PA; 2001. http://www.phila.gov/health/pdfs/DDC_Annual_Report_2000.pdf. Accessed 10 Sept 2015.
Philadelphia Department of Public Health, Division of Disease Control. 2013 Annual Report. Philadelphia, PA; 2014. http://www.phila.gov/health/pdfs/DDC_AnnualReport_2013.pdf. Accessed 10 Sept 2015.
Philadelphia Department of Public Health. Philadelphia youth in crisis: adolescents and sexually transmitted infections. Philadelphia, PA; 2011. http://www.phila.gov/health/pdfs/AdolescentsandSTIs.pdf. Accessed 16 Dec 2015.
Hagan H, Pouget ER, Williams IT, Garfein RL, Strathdee SA, Hudson SM, et al. Attribution of hepatitis C virus seroconversion risk in young injection drug users in 5 US cities. J Infect Dis. 2010;201(3):378–85.
Page K, Hahn JA, Evans J, Shiboski S, Lum P, Delwart E, et al. Acute hepatitis C virus infection in young adult injection drug users: a prospective study of incident infection, resolution, and reinfection. J Infect Dis. 2009;200(8):1216–26.
Nelson PK, Mathers BM, Cowie B, Hagan H, Des Jarlais D, Horyniak D, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011;378(9791):571–83.
Sherman SG, Patel SA, Ramachandran DV, Galai N, Chaulk P, Serio-Chapman C, et al. Consequences of a restrictive syringe exchange policy on utilisation patterns of a syringe exchange program in Baltimore, Maryland: implications for HIV risk. Drug Alcohol Rev. 2015;34(6):637–44.
El-Bassel N, Shaw SA, Dasgupta A, Strathdee SA. Drug use as a driver of HIV risks: re-emerging and emerging issues. Curr Opin HIV AIDS. 2014;9(2):150–5.
Des Jarlais DC, Friedman SR. Fifteen years of research on preventing HIV infection among injecting drug users: what we have learned, what we have not learned, what we have done, what we have not done. Public Health Rep. 1998;113:182–8.
Conrad C, Bradley HM, Broz D, Buddha S, Chapman EL, Galang RR. Community outbreak of HIV infection linked to injection drug use of Oxymorphone—Indiana, 2015. Morb Mortal Wkly Rep. 2015;64(16):443–4.
Acknowledgments
Robert Krafty has Grant support through the National Institutes of Health (R01GM113243).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Maurer, L.A., Bass, S.B., Ye, D. et al. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999–2014. AIDS Behav 20, 2922–2932 (2016). https://doi.org/10.1007/s10461-016-1393-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-016-1393-y