Prevalence of HIV-Infected Syringes during a Syringe-Exchange Program

Abstract
Syringe-exchange programs represent one attempt to slow the spread of human immunodeficiency virus type 1 (HIV-1) infection among injection-drug users.1 We evaluated such a program in New Haven, Connecticut, operated by the city's health department. The program allows injection-drug users four opportunities per week to exchange their used syringes on a one-for-one basis for clean, attached syringe—needle combinations. Our evaluation used a system of tracking and testing to record all syringes distributed and returned.2 The syringes returned were tested with the polymerase chain reaction for HIV-1 proviral DNA as evidence of use by an HIV-infected injection-drug user. Two rounds of amplification and Southern blotting lowered the limits of detection to as few as two copies of HIV-1 DNA.3

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