AIDS and Legal Access to Sterile Drug Injection Equipment

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Abstract
Legal access to sterile injection equipment has been a primary strategy for preventing the acquired immune deficiency syndrome (AIDS) among persons who inject illicit drugs in almost all developed countries. This strategy has remained highly controversial in the United States, with only a small number of localities adopting it. This article reviews different techniques of providing legal access—over-the-counter sales and syringe exchanges—research design issues relevant to evaluating legal-access programs, and the findings from the large number of studies conducted to date. The findings are consistent in showing no increase in illicit drug use related to legal access and decreases in AIDS risk behavior related to legal-access programs. The design of legal-access programs for maximal impact and the ultimate effect of the decreases in AIDS risk behavior on transmission of the human immunodeficiency virus (HIV) remain to be determined.