research needs and funding, 5, 191, 192

Bleachman, 97

Blood-borne pathogens, 27-28, 45, 149, 168, 190

workplace standard, 125

Booting, 25

Boston, Massachusetts

exchange programs, 74, 86

injection drug use estimates, 59

Boulder, Colorado, exchange programs, 82, 84, 86

Breastfeeding, 30

Bureau of Narcotics, 144

Bush administration, 144

C

CACTUS needle exchange program, 285-293

California

Bureau of Narcotic Enforcement, 121

condom use, 42

laws, 77, 147, 175

Canada

exchange program, 2, 95

needle sharing, 157

Case-control studies, 214

Amsterdam, 265

New York City, 188

Tacoma hepatitis surveillance, 242-243, 245, 246-248

Case law, 148-149

Case management, 75, 81, 82

Center for Substance Abuse Treatment (CSAT), 5, 13, 188, 190, 191

Centers for Disease Control and Prevention (CDC)

AIDS case reporting system, 23, 31, 67

bleaching recommendation, 5, 13-14, 174-175, 188-189, 190, 191

Connecticut study, 123, 152, 154, 155, 156

evaluation research, 254-255

HIV infection estimates, 32, 34, 37, 38, 39

injection drug use estimates, 58-59, 63

Central Intelligence Agency, 117

Chancroid, 29

Chicago, Illinois

bisexual transmission, 40-41

bleach distribution programs, 177-178, 180-186, 192n

exchange programs, 84, 224-225, 293-304

HIV prevalence, 38

injection drug use, 59, 67, 224-225

intranasal heroin use, 68

public opinion, 114

Chlorine demand, 171

Churches, 117, 118-120

Circulation models, 86, 87, 228-229, 230-231, 255n, 302

Cleaning, 170, 177

Cocaine, 25, 26-27, 40, 43, 57-58, 65, 66, 67, 117.

See also Crack

Community availability, 149, 157

Community-based studies, 64, 66-68, 69, 265

Community concerns and responses, 5-6, 103-104, 133-137, 252, 253254, 272-273

African Americans, 107, 110, 111, 114-115, 116-120, 134, 136

Latino/Hispanic population, 117, 120-121, 134, 273

law enforcement officers, 104, 121-123, 133, 134, 136, 156, 273

moral and ethical arguments, 105-106

pharmacists, 104, 123-126, 135, 136, 156, 273

public opinion polls, 4, 104, 106-107, 108-115, 133, 136

treatment service providers, 104, 126-133, 135, 136, 273

Community Epidemiology Work Group (CEWG), 66-68, 69

Comparison and cross-sectional studies, 93, 95, 201, 202

FRONT MATTER (R1-R18)

EXECUTIVE SUMMARY (1-8)

INTRODUCTION (9-20)

PART 1 DIMENSIONS OF THE PROBLEM (21-22)

1 THE EPIDEMIOLOGY OF HIV AND AIDS (23-56)

2 THE EPIDEMIOLOGY OF INJECTION DRUG USE (57-73)

3 NEEDLE EXCHANGE AND BLEACH DISTRIBUTION PROGRAMS IN THE UNITED STATES (74-102)

4 COMMUNITY VIEWS (103-142)

5 THE LEGAL ENVIRONMENT (143-164)

PART2 THE IMPACT OF NEEDLE EXCHANGE AND BLEACH DISTRIBUTION PROGRAMS (165-166)

6 THE EFFECTIVENESS OF BLEACH AS A DISINFECTANT OF INJECTION DRUG EQUIPMENT (167-197)

7 THE EFFECTS OF NEEDLE EXCHANGE PROGRAMS (198-262)

8 DIRECTIONS FOR FUTURE RESEARCH (263-278)

APPENDIXES (279-280)

A DESCRIPTION AND REVIEW OF RESEARCH PROJECTS IN THREE CITIES (281-306)

B PROFESSIONAL ASSOCIATION POSITIONS ON NEEDLE EXCHANGE AND BLEACH... (307-312)

C BIOGRAPHICAL SKETCHES (313-320)

INDEX (321-334)