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The spread of HIV infection among injection-drug users (IDUs) is a public health emergency. One preventive approach is a needle-exchange program through which IDUs can obtain uncontaminated needles for injection. Opponents of such programs often cite an early report from a large needle-exchange program in Vancouver, British Columbia, showing an association between frequent needle exchange and elevated HIV rates. Now, researchers have evaluated this association using data obtained during extended follow-up of 1035 initially HIV-seronegative IDUs who were recruited into the Vancouver program from May 1996 through December 2004 and returned for at least one follow-up. In this group, 31% exchanged needles daily; the others did so less often.
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