638a. Reduction in Injection Risk Behaviors after Institution of an Emergency Syringe Exchange Program during an HIV Outbreak among Persons Who Inject Drugs, Indiana 2015
Session: Oral Abstract Session: Featured Oral Abstract
Thursday, October 8, 2015: 4:45 PM
Room: 20--ABCD
Background: On April 6, 2015, an emergency syringe exchange program (SEP) was implemented in response to an unprecedented HIV outbreak linked to injection drug use in a small rural Indiana community. To assess impact of the SEP, we compared injection-related risk behaviors reported over time.

Methods: At each SEP visit, clients received sterile syringes, a wound kit, harm reduction education, and referrals to health and substance abuse services. Returned syringes were safely disposed and clients were surveyed about current risk behaviors. We analyzed data on clients with >2 SEP visits ≥7 days apart through June 6, 2015. Differences in medians and percentages between clients’ first and most recent visit were assessed using the Kruskal-Wallis test, or chi-square or Fisher exact test.

Results: We evaluated data from 100 qualifying SEP clients who contributed a total of 361 visits (median: 3) and received 19,376 syringes: 55% were male, median age was 33 years (interquartile range [IQR]: 26-40). The median interval between first and most recent visit was 27 days (IQR: 16-40). Sharing syringes to inject declined significantly by 85% between the first and most recent visits (Table). The frequency of reusing the same syringe also declined significantly. The number of syringes returned and distributed both increased significantly. Decreases in sharing syringes to divide drugs and sharing other injection equipment were not statistically significant.

Conclusion: Among clients enrolled during the first two months of an emergency SEP, many injection-related risk behaviors declined significantly. Emergency SEPs can rapidly reduce risk behaviors capable of transmitting HIV in an outbreak setting.

Table. Risk behaviors reported by emergency syringe exchange program clients, by visit, Scott County Indiana, April 6-June 6, 2015 (n=100)


First visit

Most recent visit


Sharing syringes to inject, n (%)

34 (34%)

5 (5%)


Median frequency of syringe reuse, n (interquartile range [IQR])

4 (2-15)

1 (1-1)


Median syringes returned, n (IQR)

0 (0-1)

47 (27-80)


Median syringes given, n (IQR)

35 (21-56)

42 (30-70)


Sharing syringes to divide drugs, n (%)

38 (38%)

10 (10%)


Sharing other injection equipment, n (%)

44 (44%)

11 (11%)


Monita R. Patel, PhD, MPH1, Brittany Combs, RN2, Patti Hall, BS2, Jill Hough, BA2, Erika Chapman, MPH, CPH, CHES3, Andrea Perez, BA3, John T. Brooks, MD1, Philip J. Peters, MD1 and Dita Broz, PhD, MPH1, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Scott County Department of Health, Scottsburg, IN, (3)Indiana State Department of Health, Indianapolis, IN


M. R. Patel, None

B. Combs, None

P. Hall, None

J. Hough, None

E. Chapman, None

A. Perez, None

J. T. Brooks, None

P. J. Peters, None

D. Broz, None

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