Delivering syringe exchange services through “satellite exchangers”: the Sacramento Area Needle Exchange, USA |
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Authors: | Rachel Anderson Lynell Clancy Neil Flynn Alex Kral Ricky Bluthenthal |
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Institution: | a Department of Internal Medicine, Division of Infectious Diseases, University of California, Davis Medical Center, 4150 V Street, Suit 500, Sacramento, CA 95817, USA;b Urban Health Studies, Department of Family and Community Medicine, UC, San Francisco, CA, USA;c Health Program, RAND & Center of AIDS, Research, Service, and Education, Department of Psychiatry, Charles R. Drew University, Madison, NJ, USA |
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Abstract: | An important operational aspect of Syringe Exchange Programmes (SEPs) is the venue of service delivery. This report describes the programmatic features of the Sacramento Area Needle Exchange (SANE), an illegal SEP operating in California, USA. SANE utilises “satellite exchangers” to distribute the bulk of its syringes and HIV risk reduction supplies. Advantages of relying primarily on Designated Exchangers (DE) for delivery of SEP services are that it: (1) allows for coverage of a large geographical area; (2) keeps operational cost low; (3) provides syringes to clients who may not want to or cannot use fixed site programmes; (4) limits the possibility of detection of programme personnel and clients by law enforcement. Limitations are that: (1) it is not as conducive as fixed sites to providing a wide range of ancillary services; (2) it may not be optimal for drug users who do not want to be reliant on other people for access to syringes; (3) those who receive services from a satellite exchanger may not derive as much counselling and referral services as direct exchangers. The lack of legal status, political support and adequate funding threatens the programme’s existence. |
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Keywords: | Syringe exchange Satellite/secondary exchange Delivery HIV prevention Policy Legal status |
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