TABLE 7.2 GAO Review: Results of Needle Exchange Program Study Projects

Project Number

by Country

Needle Sharing

Prevalence of

Injection

Frequency of

Injection Drug Use

Australia

 

 

 

1

 

a

 

Canada

 

 

 

2

 

 

 

Netherlands

 

 

 

3

 

 

a

4

Reduction

 

Reduction

Sweden

 

 

 

5

 

 

 

United Kingdom

 

 

 

6

 

 

 

7

 

 

Reduction

8

Increase

 

 

United States

 

 

 

9

Reduction

 

a

a GAO reported these as showing no increase; however, a review of the original studies indicates that no statistically significant findings were reported for the outcome measure assessed.

SOURCE: Adapted from Needle Exchange Programs: Research Suggests Promise as an AIDS Prevention Strategy (U.S. General Accounting Office, 1993:7).

all five projects that reported findings on injection drug use by program participants—four on frequency of injection and one on prevalence of use—found that use did not increase. (Note that three of these findings did not reach statistical significance.) This led GAO to conclude that ''some research suggests programs may reduce AIDS-related risk behavior" (p. 6) and "most projects suggest that programs do not increase injection drug use" (p. 8). GAO reported that there was sufficient evidence to suggest that needle exchange programs "hold some promise as an AIDS prevention strategy" (p. 4).

In summary, the GAO report, which was the first government report to evaluate needle exchange programs, concluded that such programs hold promise as interventions to limit HIV transmission. The criteria for assessing the validity of the study findings and for including reports in the review were quite stringent. In particular, the criterion of statistical significance means that studies that showed no difference in the frequency of injection or needle sharing were excluded. Therefore, the argument that needle exchange programs cause no harm is not fully characterized because studies



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