STAGE 4. Selecting the theoretical approach

What steps should be completed?

Step 1: Select the theoretical approach or approaches on which the intervention will be based

SYRINGE EXCHANGE PROGRAMMES

What are their bases?

Syringe exchange programmes (SEP) emerged in the mid-1980s in the Netherlands, Australia and the United Kingdom with the aim of reducing the risk of HIV-AIDS and hepatitis B transmission by infected injection material used by intravenous drug users. SEP promote the use of sterile, accessible and free syringes to injecting drug users.

Practical implications

In addition to delivering sterile material and removing used material, many SEP include services such as delivery of kits that contain new syringes, alcohol wipes and condoms, information on safer injection techniques, HIV-AIDS, hepatitis and other infectious diseases, social and health resources and care services for drug users, and basic health care (small remedies, etc.).

While all SEP have the same goal: to deliver sterile syringes in exchange for used ones, the way in which the exchange takes place differs significantly in two elements:

• Programme location: syringes can be supplied through stable premises and mechanisms, such as drug treatment centres and health centres (which allows other complementary objectives to be introduced), pharmacy offices (normalises the intervention), dispensing or exchanging machines (which provide a wide timetable and guarantee anonymity), mobile devices (they bring the supply to the points of use) and penitentiary centres.
• The staff involved in the distribution/exchange, which can be carried out by health workers, social educators, former intravenous drug users or active drug users.