Kaplan E H
Yale School of Organization and Management, New Haven, CT 06520.
Infect Agents Dis. 1992 Apr;1(2):92-8.
Needle exchange programs have been implemented in many cities around the world to slow the spread of human immunodeficiency virus (HIV) infection among injecting drug users. Whether these programs are succeeding in reducing HIV incidence is a matter of debate, as is the appropriateness of sanctioning the provision of drug injection equipment in the midst of a "war on drugs." In a debate swollen with emotional arguments on both sides of the issue, scientific research is essential, lest discussion of needle exchange becomes needless exchange at the policy level. This article briefly outlines and critiques the common arguments for and against needle exchange. Following this, a new circulation theory of needle exchange is advanced, along with supporting evidence from an ongoing study in New Haven, CT, U.S.A. Finally, several open questions relating to the operation of needle exchange programs and the behavior of program clients are suggested for further investigation.
世界上许多城市都实施了针头交换项目，以减缓注射吸毒者中人类免疫缺陷病毒（HIV）感染的传播。这些项目是否成功降低了HIV发病率存在争议，在“禁毒战争”中批准提供注射吸毒设备是否合适也存在争议。在这个问题的双方都充斥着情绪化争论的辩论中，科学研究至关重要，以免在政策层面上关于针头交换的讨论变成毫无意义的交流。本文简要概述并批评了支持和反对针头交换的常见论点。在此之后，提出了一种新的针头交换循环理论，并给出了美国康涅狄格州纽黑文市一项正在进行的研究的支持证据。最后，提出了几个与针头交换项目的运作和项目客户行为相关的开放性问题，以供进一步研究。
