Life After the Ban: An Assessment of US Syringe Exchange Programs’ Attitudes About and Early Experiences With
Published in the American Journal of Public Health
By Erika G. Martin and others
ABSTRACT: Despite the temporary removal of a ban on federal funds for syringe exchange programs (SEPs), few programs received federal financial support during 2010-2011 as they faced multiple barriers to accessing the money, this study finds.
Syringe exchange programs, which provide clean hypodermic needles to injection drug users, are intended to prevent the spread of HIV and viral hepatitis. Though controversial since their inception, they have been found to be effective and cost-effective interventions. Their number and impact in the U.S., however, has been limited by federal, state and local laws as well as law enforcement practices.
This study, led by Traci C. Green of Rhode Island Hospital and
Lifespan/Tufts/Brown Center for AIDS Research, was undertaken to determine discrepancies between the promise of the funding-ban removal and its “street-level impact” in the initial stages of implementation. Through a telephone survey of SEPs around the country, Green, Martin and colleagues examined several things: whether SEPs currently received federal funding explicitly for syringe exchange and distribution activities; whether SEPs anticipated pursing federal funding; and the barriers to acquiring federal funds under the draft implementation guidelines from the U.S. Department of Health and Human Services (HHS).
A common barrier to obtaining federal funding was the requirement that SEPs obtain annual certifications from local public health or law enforcement agencies to verify the appropriateness and location of their operations. Another was lack of internal resources to apply for financial support and comply with funding regulations.
The ban on federal funding to these programs has now been reinstated. The availability of federal funding for the two-year period studied was largely symbolic, researchers conclude. In practice, funding opportunities may not be available to all SEPs. Access to federal funds could be improved through legal reform and increased technical assistance, especially for smaller SEPs with tenuous local support.