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

Abstract

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.

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By comparing differences among US state laws, the authors found association of public funding of syringe exchanges with lower rates of HIV infection, greater numbers of syringes distributed, and greater numbers of health and social services.

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Bramson, H., Des Jarlais, D., Arasteh, K. et al. State laws, syringe exchange, and HIV among persons who inject drugs in the United States: History and effectiveness. J Public Health Pol 36, 212–230 (2015). https://doi.org/10.1057/jphp.2014.54

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Keywords

  • HIV
  • PWID
  • drugs
  • laws
  • syringe exchange
  • pharmacy sales