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It is better to beg forgiveness, then to ask permission: a chronicle of Prevention Point needle exchange.
Downing M; Case P; Clark G; Dietrich R; Garcia D; Prem R; Prevention
December 30, 1990
Int Conf AIDS. 1990 Jun 20-23;6(2):418 (abstract no. 3067). Unique

OBJECTIVE: To demonstrate the effectiveness of a street-based needle exchange (NE) program, to continue building support in ethnically diverse communities, and to affect public opinion and public health policy. METHODS: Prevention Point (PP) committed civil disobedience to challenge existing paraphernalia laws. PP created an anonymous, street-based NE program using focus groups of potential clients and ethnographic mapping of potential sites. PP collaborated with many diverse organizations to expand to additional neighborhoods, and to move public policy toward establishing a sanctioned NE program. RESULTS: On Wednesday, 1/17/90, 2620 needles were exchanged with 427 clients. In the 15 months that PP has operated, 53,132 syringes have been exchanged with 10,856 client contacts. Apparent demographic information was collected. Of these contacts, 2497 (23%) were women, 8302 (76%) were men, and 57 (.5%) were of unknown gender. Of these, 101 (.9%) were Asian, 3113 (29%) were Black, 1174 (11%) were Latino, 74 (.6%) were Native American/Alaskan Native, 6329 (58%) were White, and 65 (.5%) were from other ethnic groups. Two leading AIDS advocacy groups, The Latino Coalition on AIDS/SIDA and The Third World AIDS Advisory Task Force, joined in coalition with PP and established a third site. Following publicity around the PP program and accompanying public pressure, a coalition of community-based organizations, drug treatment, health, and human service agencies formed the Needle Exchange Community Task Force. The Task Force developed a protocol for comprehensive HIV intervention among IDUs which includes NE. CONCLUSIONS: PP has increased the options available for HIV prevention to IDUs, has created a broad base of community support for NE, and has pushed local health and city officials to establish NE as public policy. With $360,000 budgeted for NE in the Mayor's HIV Task Force Report, and official public policy supporting NE, it is clear that archaic paraphernalia laws are the only obstruction to San Francisco's sanctioned NE program.

Female Health Policy Human HIV Infections/*PREVENTION & CONTROL Male *Needles *Program Evaluation *Public Opinion *Substance Abuse, Intravenous ABSTRACT