Psychosocial and behavioral differences among drug injectors who use and do not use syringe exchange programs.

Most research on the benefits of syringe exchange programs (SEPs) has focused on assessing program effectiveness and identifying risk profiles of SEP customers. To our knowledge, no empirical studies have considered the psychosocial characteristics of IDUs who do and do not use SEPs. To determine whether IDUs who do and do not use SEPs differ along demographic, psychosocial, and HIV risk characteristics and behaviors, we analyzed data from a three-city (Chicago, IL; Hartford, CT; Oakland, CA) observational study of how HIV prevention messages and supplies diffuse from SEPs. The study sample consisted of 350 participants with no reported history of HIV, hepatitis B or C virus infection. Self-efficacy was the only psychosocial factor to differentiate SEP customers from all non-customers groups; injecting others and pre-injection cleaning of the injection site differentiated some non-customers from customers. Implications for future interventions are discussed.