The purpose of expanded-access programs (EAPs) for antiretroviral therapy has been to allow patients without alternative treatment options to obtain drugs before formal Food and Drug Administration approval. Given the dramatic changes that have occurred in antiretroviral therapeutic approaches during the past 2 decades, we wish to review the history of antiretroviral EAPs and to propose an upda...

OBJECTIVE To analyze the cost-effectiveness of New York State-approved syringe exchange programs (SEPs) and estimate the cost-saving potential of these programs. DESIGN AND METHODS The cost-effectiveness analysis used cost and process data provided by seven SEPs for the calendar year 1996 or the most recent 12-month period available at the time of the study. Alternative estimates of the numbe...

BACKGROUND The Mexico-U.S. border region is experiencing rising rates of blood-borne infections among injection drug users (IDUs), emphasizing the need for harm reduction interventions. METHODS We assessed the religious and cultural factors affecting the acceptability and feasibility of three harm reduction interventions--Needle exchange programs (NEPs), syringe vending machines, and safer in...

t h, I was invited to meet with health staffers from various congressional representatives in Washington, D.C., to discuss the moral imperatives of supporting needle exchange programs, which increase the availability of sterile syringes with the goal of preventing Hepatitis B and C, HIV and other blood-borne infections. My invitation came from the Interfaith Drug Policy Initiative, which is wor...

Recent data suggest that globally, between 5% and 10% of all new HIV cases are the result of unsafe injecting practices, and experts agree that reducing these practices is key to tackling the spread of HIV. And yet, despite the overwhelming evidence that providing sterile syringes to injection drug users (IDU) through syringe exchange programs (SEPs) or other means is an effective way of reduci...

The present study aims to evaluate the current operation of Brazilian syringe exchange programs (SEP). After consulting national and regional networks of people working in projects/programs aiming to reduce drug-related harm, we identified 134 potential participant programs. Unfortunately, only 45 SEPs answered a survey, even after repeated attempts. The survey addressed: coverage, funding, pro...

In the last two decades there has been a growing interest surrounding the topic of clean needle exchange programs, the effects they have on injection drug users, their effectiveness in the prevention and spreading of HIV, AIDS and other blood borne pathogens, the cost surrounding the operation of NEPs and SEPs, and their beneficialness on society as a whole. The objective of this research paper...

BACKGROUND Needle-syringe exchange programs (NSPs) have been substantially rolled-out in China since 2002. Limited studies reported effectiveness of NSPs in a Chinese setting. This study aimed to assess the association between accessibility to NSPs and drug-use risk behaviors of IDUs by investigating primary (self-reported) data of IDUs recruited from NSP sites, community settings and mandatory...

This study assessed 1,144 Brazilian injecting drug users (IDUs) recruited on the street through outreach syringe exchange programs by two multi-center cross-sectional studies: 287 IDUs were recruited during the AjUDE-Brasil I Project and 857 during the AjUDE-Brasil II Project. IDU characteristics related to drug use and sexual behavior, and legal and health conditions for the two studies were c...

BACKGROUND The applicability of water method colonoscopy in trainee education is not known. AIM To compare the water method vs. usual air method in teaching novice trainee colonoscopy. METHOD An IRB approved prospective randomized cross-over study (NCT01482546) in a university setting with diverse patient population. DESIGN Three first year GI fellows consented to participate in the study...