Needle exchange and AIDS prevention: controversies, policies and research.

This paper reviews the key public health issues, social science research, and policy debates that surround the issue of needle exchange as an AIDS prevention strategy among injection drug users. As worldwide rates of drug use-related HIV infection and injection drug use have continued to rise, there is growing public health pressure to identify effective prevention strategies. Needle exchange, while consistently found to be effective in lowering AIDS risk and in preventing new HIV infection, remains a controversial issue in the U.S. because this "harm reduction" approach fails to condemn drug use, suggesting the underlying moral issues in an increasingly intense public policy conflict.