Drug-Injecting Street Youth: A Comparison of HIV-Risk Injection Behaviors between Needle Exchange Users and Nonusers

Injection drug use, the second most common risk factor associated with HIV infection in the United States after sexual transmission, is especially prevalent among street youth, many of whom routinely share their drug injection equipment. To prevent sharing behavior among street youth, a needle exchange program for youth was established in Hollywood, California. This study compared the drug use and needle-sharing behaviors of youth who were users of the needle exchange with those of youth who were not. Results indicate that while demographic characteristics and drug injection frequency were similar in the two groups, needle exchange users were significantly less likely to share needles, share other injection equipment, use other drugs to help them "come down," use unsterile needles when "high" or "craving" drugs, and report difficult access to sterile needles. These findings suggest that needle exchange programs may reduce needle-sharing behavior among street youth.