ISSUE: Needle exchange is pivotal to HIV prevention among IDUs but it is only one of the needed components to accomplish this goal. Indeed, needle access can't do much by itself for such key issues as social disorganization, deathwishes or lack of self-esteem. PROJECT: Point de Reperes is a Canadian prevention programme aimed at preventing STDs and AIDS among IDUs. Inspired by harm reduction strategies, our programme reaches around 8,000 IDUs by reaching out to them in the streets, detention center and shooting galleries of Quebec city. We offer needle exchanges as well as condom distribution, vaccination against hepatitis B and anonymous testing for HIV. We are also there for the individuals who need someone to talk to. We support, refer, and accompany our clients to the appropriate ressources. Our outreach activities go beyond knowledge transfer about HIV and are aimed at skill building. Numerous collaborators among correctionnal, health, epidemiology, evaluation, and drug abuse institutions allow us to fine-tune our work to the reality of IDUs. RESULTS: Since its implementation in 1991, Point de Reperes distributed around 100,000 syringes per year and recovered around 82,000 of those. Moreover, we have observed increasing numbers of drug-free periods among our clients. LESSONS LEARNED: The support we offer has allowed us to establish a relationship of trust with the IDUs we serve. This has made it possible, in view of the service continuum we offer, to make IDUs feel responsible for their own injection material and sexual behaviors.

MEETING ABSTRACTS Acquired Immunodeficiency Syndrome/*PREVENTION & CONTROL/ PSYCHOLOGY Combined Modality Therapy Health Resources Human *Needle-Exchange Programs Quebec Sexually Transmitted Diseases/*PREVENTION & CONTROL/PSYCHOLOGY Substance Abuse, Intravenous/PSYCHOLOGY/*REHABILITATION *Urban Population

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