First, the provision of sterile syringes and other drug consumption equipment should not be made conditional upon the exchange of used syringes.
One common public health response to the emergence of HIV has been the provision of sterile syringes to people who inject drugs.
This policy study did not address health systems support issues, such as training staff in diagnosing and treating gestational syphilis, continuous provision of consumables (syringes, test kits, drugs, etc)., and supporting district management teams in terms of programming and supervision.
Injecting drugs in prison is particularly risky because the often copious drug supply is not associated with liberal provision of clean syringes or the means to sterilise used injecting equipment.
In addressing ethical issues, the Project on Harm Reduction concludes that not only is provision of sterile syringes to drug users ethical, but also that "physicians treating patients who inject drugs are, at least in the absence of legal limits, obliged by their own professional standards to consider providing this care to patients who need it".
UNICEF is supporting the Ministry of Health with the provision of vaccinations and syringes, cold chain equipment and the training of vaccinators.
Some believe providers will continue to re-use injection equipment, and this is certainly likely where provision of auto-disable syringes are not assured.
The most important implication of our study is that only when methadone is combined with provision of needles and syringes through exchange programmes is there a significant reduction of HIV and HCV incidence.
This currently includes provision of needle and syringe exchange programs, condom distribution, opioid substitution therapy (recently evaluated [ 9]), treatment for sexually transmitted infections (STIs), and behaviour change communication.
A combination of harm reduction strategies, such as the provision of new needles and syringes and treatment of substance use, decreases the risk of hepatitis C in intravenous drug users by about 75%.
