Perhaps the most studied social intervention is that of increasing access to sterile syringes for those who use injected drugs. Although such drug use is illegal nearly everywhere in the world, many countries have adopted harm reduction policies that allow, if not provide, for access to sterile injecting equipment for those who continue to inject. The implementation of needle/ syringe-exchange programmes, in particular, has resulted in decreased needle-sharing and related practices, and reduced HIV incidence and prevalence in numerous locales (124, 132-136). A review of data from 81 cities across Europe, Asia, and North America with and without syringe-exchange programmes found that, on average, HIV prevalence among injecting drug users increased by 5.9% per year in the 52 cities without exchange programmes and decreased by 5.8% per year in the 29 cities with exchange programmes. Thus the average annual change in prevalence was 11% lower in cities with exchange programmes (132). But political resistance to strategies that may be construed as condoning drug use has prevented many countries and cities from implementing exchange programmes and other harm reduction interventions.
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