Journal of Public Health Policy

, Volume 36, Issue 2, pp 212–230 | Cite as

State laws, syringe exchange, and HIV among persons who inject drugs in the United States: History and effectiveness

  • Heidi Bramson
  • Don C Des Jarlais
  • Kamyar Arasteh
  • Ann Nugent
  • Vivian Guardino
  • Jonathan Feelemyer
  • Derek Hodel
Original Article


In 1981, when acquired immune deficiency syndrome (AIDS) was first observed among persons who inject drugs, almost all US states had laws criminalizing the possession and distribution of needles and syringes for injecting illicit drugs. We reviewed changes to these laws to permit ‘syringe exchanges’ and the provision of public funding for such programs. Most of the changes in law occurred during the 1990s, 5–10 years later than in many other countries. Public funding of syringe exchanges is associated with lower rates of human immunodeficiency virus (HIV) infection, greater numbers of syringes distributed (a possible causal mechanism), and greater numbers of health and social services provided. Experience in the United states may prove useful in other countries: state, provincial, and local governments may need to move ahead of central governments in addressing HIV infection among persons who inject drugs.


HIV PWID drugs laws syringe exchange pharmacy sales 


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Copyright information

© Palgrave Macmillan, a division of Macmillan Publishers Ltd 2015

Authors and Affiliations

  • Heidi Bramson
    • 1
  • Don C Des Jarlais
    • 1
  • Kamyar Arasteh
    • 1
  • Ann Nugent
    • 1
  • Vivian Guardino
    • 1
  • Jonathan Feelemyer
    • 1
  • Derek Hodel
    • 2
  1. 1.Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth IsraelNew YorkUSA
  2. 2.amfARWashingtonUSA

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