“Syringe exchange is used by various categories of abusers, and the patterns of use vary greatly. This concerns how long they participate, how often they make their visits, and what services they request,” says Nils Stenström. One surprising finding was that a large proportion of the visitors, nearly half, visited the clinic without exchanging syringes. These visits are social in nature – nevertheless they are connected with reduced risks of infection. This shows that the associations between syringe exchange, risk behaviour, and infection risks are complex, according to Stenström.
The studied followed 3,660 injecting abusers taking part in the syringe exchange program in Malmö, Sweden, over a 15 year period. Nearly 180,000 visits served as the basis for comprehensive analysis of how the program is used and developments regarding contagion, HIV and hepatitis testing, vaccinations, and social development. The study is probably the largest ever undertaken in the world of the long-term effects of a syringe exchange program.
Analyses of the visits data reveal that the longer individuals participate in the program, the more often they visit the clinic. But the hope that syringe exchange would constitute a springboard to regular public care and treatment options for drug abusers was not realized to any great extent. On the other hand, the clinic itself, through extensive testing, vaccination, and counseling, did take on an important role in general preventive health efforts.
The title of the dissertation is Syringe exchange for injecting drug users – A longitudinal study of participants in a syringe exchange programme in Malmö, Sweden.