American Psychiatric Association (APA)

APA Policy on Clean Needle and Syringe Exchange: Addiction treatment on demand may be the most effective means of reducing HIV transmission among injecting drug users (IDUs). Treatment on demand, however, does not exist in most areas where injecting drug use is prevalent. In addition, a significant number of IDUs do not seek treatment. The APA recommends that clean needle and syringe exchange programs be developed and independently evaluated in terms of their efficacy in reducing HIV transmission and their impact on the prevalence of injecting drug use. The APA believes that those areas where treatment on demand is available are the most appropriate sites for evaluating this promising but unproven intervention. Further, the APA supports all efforts to increase addiction treatments to meet the need.

American Psychological Association (APA)

No response was received.

American Public Health Association (APHA)

Policy: In 1989, APHA passed a policy resolution, "Illicit Drug Use and HIV Infection," that addresses the issue. Our policy process requires that resolutions be based on scientific fact. Because of the lack of research findings on needle exchange at that time, the policy only goes so far as to call for the research and evaluation of needle exchange programs. The AIDS Working Group of APHA's Special Initiative on AIDS is drafting a new policy on needle exchange which will take into account current research and will be submitted for the 1994 policy resolution process.

Commentary: Public health strategies such as needle exchange and bleach distribution are critical components necessary to fight the twin epidemics of substance abuse and HIV infection. In January 1990, APHA's Special Initiative on AIDS published a report on "Illicit Drug Use and HIV Infection." The reports in the AIDS series are sold to our members and the general public for a low price and are a good source of basic information on topics such as needle exchange. This particular report examines needle exchange and bleach distribution programs, and contains an appendix that describes programs that existed at that time.

American Society of Addiction Medicine (ASAM)

Background: Needle Exchange Programs are a crucial component of a spectrum of HIV prevention services to drug injectors which effectively



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