Risk reduction among intravenous drug users in Amsterdam under the influence of AIDS

We evaluated the impact of a needle/syringe exchange program among 263 drug users in the period December 1985 to April 1988. Participants in this study were asked about their risk-behavior at three different visits. We found no increase in the proportion injecting drugs or in the frequency of intravenous drug use. A strong decrease in borrowing and lending of used needle/syringes was found and this behavioral change was not dependent on learning human immunodeficiency virus (HIV) serostatus. Although use of the exchange program increased over time, reduction in needle sharing was mainly an effect of the study with only a limited impact of the exchange program. We conclude that ample provision of needles and syringes is an important starting point but in itself not enough to produce the necessary drastic change in risk behavior. Intensive counseling of the drug user is also needed.