A stationary van site consists of a van parked at a predictable location at a predictable time. One van may visit multiple fixed sites in a single outing. A van exchange is a way for needle exchange programs to provide the benefits of both a fixed and a mobile site. It can provide shelter for staff, some privacy for clients, and consistent service while covering a large geographic area.
A storefront program provides shelter for participants and staff. It can also provide privacy for injection drug users, especially if the storefront houses other programs and services not directly related to injection drug use. Storefront sites can also house telephones, facsimile machines, computers, desks, and chairs, which can make it easier for needle exchange program staff to provide services to injection drug users and facilitate referrals to other services. Storefront needle exchange programs may involve significant rental costs.
A street site is located on a sidewalk with either a card table to hold the items to be distributed or persons holding bags containing the items. Participants can blend in with the foot traffic as they approach the table to pick up condoms, peruse the available literature, or ask a question about AIDS. Injection drug users are not the only persons to approach the needle exchange program table and thus their privacy can be protected.
Housing a needle exchange program in a health facility can also provide shelter and privacy. Such sites also facilitate referral of injection drug users to other services, especially if these services are also provided within the health facility. However, health facilities can present geographic and psychological barriers to injection drug users. The needle exchange program may be located in a public health building in an area of low injection drug use activity. Many injection drug users may not feel comfortable entering institutional buildings, particularly ones in close proximity to other government buildings (e.g., police headquarters).
Needle exchange program services provided on walk routes generally target areas known to have high concentrations of injection drug users. A roving site of this sort generally follows a relatively consistent route, although it can change in response to immediate neighborhood conditions (e.g., increased police presence) or to incorporate additional populations of injection drug users.
Deliveries bring needle exchange program services directly to injection drug users. In many ways, deliveries are the most private type of site, in that they meet the injection drug user at a location of his or her choice. However, deliveries require access to transportation, are labor intensive, and may present many logistical challenges.
Roving vans allow a needle exchange program to cover a greater geographic area. A roving site keeps staff members relatively inconspicuous to neighbors, local businesspeople, and police officers.