Fact Sheet

Needle Exchange Programs Promote Public Safety

Document Date: May 31, 2006

Fact Sheet on Needle Exchange Programs
Injection Drug Use and Infectious Disease Make Needle Exchange Programs Imperative:

  • There are an estimated 350,000 regular injection drug users in America – all at increased risk of contracting and spreading fatal blood-borne diseases. 1

  • Approximately 950,000 U.S. residents are living with HIV/AIDS. 2

  • More than a quarter of AIDS cases in the U.S. among people age 13 or older are directly linked to injection drug use. 3

  • When mother-to-child HIV transmission is taken into account, roughly 35 percent of all AIDS infections can be related to injection drug use. 4

  • An estimated 61 percent of AIDS cases among women are due to injection drug use or sexual contact with someone infected with HIV through injection drug use. 5

  • Over half of HIV infections in children result from injection drug by a parent. 6

  • AIDS is the second leading cause of death among African American women and third leading cause of death among African American men. 7

  • Injection drug users are also at serious risk of contracting Hepatitis B and Hepatitis C. Hepatitis B infects between 140,000 and 320,000 people every year and kills between 5,000 and 6,000 people in the U.S. Hepatitis C infects about 36,000 people in the U.S. every year, killing 8,000 to 10,000 of those infected. 8

Needle Exchange Programs by the Numbers:

  • There are approximately 185 needle exchange programs (NEP) operating nationwide. 9

  • A national survey of NEPs found that in addition to exchanging sterile syringes for contaminated ones, 97 percent of programs provide a range of public health services, including referral to substance abuse treatment, prevention education for sexually transmitted diseases, HIV counseling and testing, tuberculosis screening, and primary health care. 10

  • It costs an average city about $160,000 to run an NEP (about $20 per user per year), whereas one syringe-infected AIDS patient will require upwards of $120,000 per year in public health expenditures. 11

  • Federal law forbids use of federal funds to support needle exchanges – nonetheless, exchanges operate in 38 states. 12

Needle Exchange Programs Promote Public Safety:

  • In 2002, NEPs reported removing nearly 25 million used syringes from communities. 13

  • According to the Centers for Disease Control, the one-time use of sterile syringes remains the most effective way to limit HIV transmission associated with injection drug use. 14

  • A study by the National Institutes of Health found that NEPs “show a reduction in risk behaviors as high as 80 percent in injecting drug users…” 15

  • NEP participants have been found five times more likely to enter drug treatment than those who had never used an exchange. 16

  • NEPs throughout the country have reduced HIV transmission rates by one-third to two-fifths. 17

  • An analyses of a New York State-approved NEP found that during a 12-month period, an estimated 87 HIV infections were averted as a direct result of the use of needle exchange. 18

  • Injection drug users who are afraid of being arrested while carrying drug paraphernalia are 1.74 times more likely to share syringes, and 2.08 times more likely to share injection supplies than other users. 19


1. Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2003 National Survey on Drug Use & Health

2. National Institute of Allergy and Infectious Diseases: HIV/AIDS Statistics

3. Centers for Disease Control and Prevention (CDC): AIDS cases by exposure category

4. CDC: Drug Associated HIV Transmission

5. CDC: HIV Surveillance Report

6. CDC: HIV Surveillance Report

7. CDC

8. National Institute of Allergy and Infectious Diseases: Hepatitus fact sheets

9. Drug Policy Alliance

10. Paone D, Clark J, Shi Q, Purchase D, Des Jarlais DC. Syringe exchange in the United States, 1996: A national profile. Am J Public Health 1999 Jan; 89(l):43-6.

11. Syringe Exchange in the United States: 1995 Update, HIV Capsule Report, United States Conference of Mayors, February 1996

12. Vogt RL, Breda MC, Des Jarlais DC, et al. Hawaii’s statewide syringe exchange program. American Journal of Public Health. 1998;88:1403-1404.

13. Morbidity and Mortality Weekly Report 2005;54(27):673-6.

14. CDC: Drug-associated HIV transmission continues in the U.S. 2002.

15. National Institutes of Health: Interventions to Prevent HIV Risk Behaviors. 1997 February 11-13;15(2):1-41.

16. Hagan H, et al. Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors. J Subst Abuse Treat 2000; 19(3):247-52.

17. National Institutes of Health: Interventions to Prevent HIV Risk Behaviors. 1997 February 11-13;15(2):1-41.

18. Laufer FN. Cost-effectiveness of syringe exchange as an HIV prevention Strategy. J Acquir Immune Defic Syndr 2001;28(3):273-8.

19. Blumenthal, R.N., Collateral damage in the war on drugs: HIV risk behaviors among injection drug users. International Journal of Drug Policy 10 (1999) 25-38.

Sign up to be the first to hear about how to take action.