Cleaning injecting equipment: a message gone wrong?

Over 100 syringe exchange schemes exist in the United Kingdom,' aiming at limiting the spread of HIV among drug users. The main strategy is to reduce sharing of injecting equipment by providing information about HIV and AIDS and supplying sterile equipment. If clean injecting equipment is not available the next best step is to clean used equipment properly. This approach was adopted in San Francisco in a "teach and bleach" campaign.2 Cleaning should rid the equipment of any blood products that might contain HIV. The best method is to boil the equipment, but this is rarely done and may damage some syringes. The next best method is to flush soapy cold water, then concentrated bleach, and then further cold water through the equipment, doing each step two or three times; using warm water initially may cause clotting and hence retention of blood products. We assessed knowledge of the recommended technique among drug users and drug workers.